Instructions
INSTRUCTIONS Return to the NCP Leasing web
The following sheets contain an NCP Lease Application (1 page)
and a personal financial statement (2 pages).
You can print these out and fill them in by hand (for return by mail or fax)
or you can fill them in on the spreadsheets, making them easy to email to us.
If you plan to fill them on the spreadsheets, we recommend you first make a copy of this file,
Forms.xls, so you will always have a clean, blank set of forms.
If you have any questions about these forms, please get in touch by phone, fax or email.
NCP Leasing, Inc.
2055 Reading Road, Suite 240
Cincinnati, Ohio 45202
Phone: 513 333 0221
Fax: 513 333 0887
Email: contact@ncpleasing.com
Page 1
NCP LEASING, INC.
RP EQUIPMENT LEASE APPLICATION
Submitting this application does not obligate the applicant or NCP to enter into a lease.
Please print, type or fill out all except the signature on your computer.
1. LESSEE
Company's full legal name:
State of incorporation: Fed tax ID:
Type of business:
Contact:
Street:
City, State, Zip:
Phone: Fax:
Email:
2. VENDOR/TRADE REFERENCES
Supplier City, State Account No. Contact Name Phone
3. LEAD BANK
Name of Bank/Branch Account No./Type How long Contact Name Phone
4. OFFICERS, PARTNERS or GUARANTORS
Owner(s)/Guarantor(s)
Name: Social Security No.:
Name: Social Security No.:
President
Name: Social Security No.:
Chief Financial Officer
Name: Phone:
Corporate Financial Statements are (check one): Compiled Reviewed Audited
The undersigned hereby grants permission to NCP Leasing, Inc. to obtain credit information from other sources such as
TRW Credit, Equifax, Dun & Bradstreet, etc. The applicant warrants the accuracy of the information supplied and the
Statements submitted with this Credit Application.
Signature: Name:
Title: Date:
Please return this application to:
NCP Leasing, Inc.
2055 Reading Road, Suite 240
Cincinnati, Ohio 45202
Phone: 513 333 0221
Fax: 513 333 0887
Email: contact@ncpleasing.com
NCP LEASING, INC. Personal Financial Statement
IMPORTANT: Read these directions before completing this Statement
You are applying for individual credit in your own name and are relying on your own income, or assets and not the income or
assets of another person as the basis for repayment of the credit requested.
(TYPE OR PRINT)
SECTION 1 - INDIVIDUAL INFORMATION SECTION 2 - OTHER PARTY INFORMATION
Name Name
Address Address
City, State & Zip City, State & Zip
Position and Occupation Position and Occupation
Business Name Business Name
Business Address Business Address
City, State & Zip City, State & Zip
Length of Employment Length of Employment
Res. Phone Res. Phone
Bus. Phone Bus. Phone
SECTION 3 - STATEMENT OF FINANCIAL CONDITION AS OF (DATE)
Assets In Dollars Liabilities
(Do not include asset of doubtful value.) (Omit cents)
Cash on hand and in this bank - see Schedule A $ Notes payable to banks - see Schedule G
Cash in other banks, savings & loans, etc. - see Schedule A Notes payable to other institutions - see Schedule G
U.S. Gov't & Marketable Securities - see Schedule B Notes payable to individuals and others - see Schedule G
Non-Marketable Securities - see Schedule C Due to brokers
Securities held by broker in margin accounts Accounts and Bills due
Restricted or control stocks Unpaid income tax
Real estate owned - see Schedule D Other unpaid taxes and interest
Accounts, loans and other notes receivable Real estate mortgages payable - see Schedule D
Automobiles and other vehicles Life insurance loans - see Schedule E
Other personal property Other debts - itemize
Cash value - life insurance - see Schedule E
Book value of business ventures - see Schedule F
Other assets - itemize
TOTAL LIABILITIES
NET WORTH
TOTAL ASSETS: $ TOTAL LIABILITIES AND NET WORTH
SECTION 4 - SOURCES OF INCOME
For year ended ____________ 19 ____ Annual Expenditures Contingent Liabilities
Salary $ Mortgage/rental payments Do you have any Yes No
Bonuses & Commissions Utility payments Contingent liabilities (as endorser
co-maker, guarantor?
Dividends & interest Real estate taxes & assessments
Net real estate income Taxes: federal, state & local Involvement in pending
(before debt service) legal actions?
Other income (specify) Insurance payments Other special debt or
circumstance?
Other contracts payments Contested income tax
(car payments, charge cards, liens?
(Alimony, child support or etc.)
separate maintenance income If "yes" to any question, describe
need not be revealed if you do Alimony, child support,
not wish to have it considered maintenance
as a basis for repaying this
obligation.) Other expenses
Total Income $ Total Expenditures $ Total Contingent Liabilities
Have you ever been declared bankrupt? Yes__ No__
Income tax settled through (date) ________________________________ If Yes, describe on separate sheet
Page 4
In Dollars
(Omit cents)
$
$
$
Estimated
Amounts
$
$
$
$
$
Page 5
SCHEDULE 1 - BANKS, SAVINGS & LOANS, CREDIT UNIONS (ETC.) WHERE FUNDS ARE ON DEPOSIT
Type of Deposit
(checking, Amount on
Name of Institution Location savings, etc.) Name(s) of Owner(s) Deposit
SCHEDULE B - U.S. GOVERNMENT & MARKETABLE SECURITIES
Number of shares Market Amount of loans
or face value (bonds) Description In name of Value against securities
SCHEDULE C - NON-MARKETABLE SECURITIES
Number Location and nature % Amount of loans Source of
of shares Name of corporation of business ownership In name of against securities Value Value
SCHEDULE D - REAL ESTATE (WHOLLY OR PARTIALLY OWNED)
Address and Type of % of Date Market Monthly Mortgage Mortgage
Property Title in Name of Ownership Acquired Cost Value Payment Balance Maturity
Residence
Residence
Other
Other
SCHEDULE E - LIFE INSURANCE CARRIED, INCLUDING N.S.L.I. AND GROUP INSURANCE
Cash surrender
Name of insurance company Owner of policy Beneficiary Face amount Policy loans value
SCHEDULE F - BUSINESS VENTURES
List Name & Address of any Business Venture Book Value As Your % of Your Position/Title Total Assets Line of Years in
in Which You Are a Principal or Partner Listed in Section 3 Ownership In the Business of Business Business Business
SCHEDULE G - NOTES PAYABLE
Original Loan/ Date of Maturity Unsecured/Secured Current Payment
Name and Address of Creditor Purpose of Loan Line Amount Loan Date (List Collateral) Balance Schedule
The information contained in this statement is provided for the purpose of obtaining or maintaining credit with NCP Leasing, Inc. on behalf of the undersigned, or
persons, firms, or corporations in whose behalf the undersigned may either severally, or jointly with others execute a guaranty in favor of NCP Leasing, Inc. Each
undersigned understands that NCP Leasing, Inc. is relying on the information provided herein (including the designation made as to ownership of property) in
deciding to grant or continue credit. Each undersigned represents and warrants that the information provided is true and complete and that NCP Leasing, Inc.
my consider this statement as continuing to be true and correct until a written notice of a change is given to NCP Leasing, Inc. by the undersigned. As long as a
loan or commitment to lend is outstanding, the undersigned agree to update this financial statement for NCP Leasing, Inc. annually. NCP Leasing, Inc. is authorized
to make all inquiries it deems necessary to verify the accuracy of the statements made herein, and to determine my/our credit worthiness. NCP Leasing, Inc. is
authorized to answer questions about its credit experience with me/us.
Signature (Individual) Signature (Other Party)
S.S. No. Date of Birth S.S. No. Date of Birth
Date Signed Date Signed
Page 2
Cash surrender
ally, or jointly with others execute a guaranty in favor of NCP Leasing, Inc. Each
nancial statement for NCP Leasing, Inc. annually. NCP Leasing, Inc. is authorized
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