Lease Application
MAIL
OR
FAX
Sales Person Telephone No. Equipment Cost ( ) $ Schedule of Lease Equipment (Include manufacturer, equipment, model, and serial number). Lessor is authorized to insert detailed description) PLEASE ATTACH DETAILED DESCRIPTION OF EQUIPMENT TO BE LISTED Neither seller nor any salesperson or other agent of seller is an agent of lessor. No salesperson and/or agent of seller is authorized to waive or alter any term or condition of this lease and no representation as to equipment or any other matter by seller shall in any way affect lessee's duty to pay the rent and perform its other obligations as set forth in this lease.
LESSEE (important to list legal name of entity)
Company Billing Address Telephone No. Fax No. State Organization I.D. # Nature of Business City Contact Person E-Mail Address State of Incorporation No. of Years in Business Type of Business O Non-Profit O Proprietorship O Partnership O Corporation Social Security No. State Title City State Zip Own Rent Zip Own Rent Home Phone No. Social Security No. Home Phone No. County Title Fed ID. # State Zip
PERSONAL INFORMATION ON OFFICERS, PARTNERS, OR GUARANTORS
Name Home Address Name Home Address City Title
COMPANY BANK REFERENCES - TWO YEAR HISTORY (Minimum)
Name of Bank/Branch Name of Bank/Branch How Long How Long Chkg. Acct. No. Loan Acct. No. Chkg. Acct. No. Loan Acct No. Acct No Acct No Telephone No. Telephone No. Contact Officer Contact Officer
LEASING OR TERM DEBT REFERENCES
Name Name City/State City/State Telephone No Telephone No Contact Officer Contact Officer
MAJOR TRADE REFERENCE-TWO YEAR HISTORY (Important to establish high credit & payment history)
Name City/State Acct. No Telephone No. Contact Officer
1/we hereby authorize you to whom this application is made or your agents to investigate my/our financial responsibility and credit worthiness and will provide financial statements, tax returns, etc., as you deem necessary. Such an investigation may include obtaining of a consumer credit report from a consumer credit reporting agency and I/we consent to Lessor obtaining report(s) on our credit history. I/we agree that the Advance Payment is not refundable unless application is rejected by Lessor. Applicant - Lessee By ________________________________________________________________ (If Corporation, have signed by President, Vice-President or Treasurer and give Title _______________________________________________________________ official title. If Owner or Partner, state which.)
Fleetwood Financial
A Division of IDB Leasing, Inc.
WE'RE RIGHT ON THE MONEY.
1001 Durham Avenue, South Plainfield, NJ 07080 (908) 222-2200 · (800) 828-6222 · Fax (908) 222-2201