Credit Application

Lessee Business Information :
Business Name: State Organized:
Business Address:
Business City: State: Zip:
Business Phone: ... Email:
Time in Business: ........ Fed Tax ID :

Principal Owner Information :

Principal Name: % Ownership
Principal Home Address:
Principal Home City: State: Zip:
Principal Home Phone: .... Email:
Principal Cell Phone:
Social Security Num: .......Date of Birth:
Principal Owner (2) Information :
Principal 2 Name: % Ownership
Principal 2 Home Add:
Principal 2 Home City: State: Zip:
Principal 2 Home Phone: .....Email:
Principal 2 Cell Phone:
Social Security Num: .....Date of Birth:
Bank Information
Bank Name:
Bank City: State: Zip:
Bank Contact:
Bank Phone:
Bank Account # 1:
Bank Account # 2:
Vendor Information :
Vendor Name:
Vendor Address:
Vendor City: State: Zip:
Vendor Contact:
VendorPhone: ...... Vendor Email:
Equipment Information :
Equipment Description:
Equipment Cost: ....... Term Requested:
Deal Description: ...........

By submitting this application, I (we) is (are) providing an Electronic Signature. An electronic signature, or e-signature, is any electronic means that indicates either that a person adopts the contents of an electronic message, or more broadly that the person who claims to have written a message is the one who wrote it (and that the message received is the one that was sent by this person). I (we) each individually as principals and/or guarantors of the Obligor, and on behalf of the Obligor (individually and collectively “Applicant”), hereby affirms that the foregoing information contained in this Credit Application is presented for the purpose of obtaining or maintaining credit as of the date indicated and is true, complete and correct.  Applicant understands Capital Lease Funding, Inc. dba Capital Leasing Solutions (Lender or Lessor) is relying on this statement of our financial condition in extending or continuing to extend credit to Applicant.  Capital Leasing Solutions, its affiliates, successors, designees or assigns is/are authorized to make any investigation of Applicant’s credit either directly or through any agency employed by Capital Leasing Solutions for that purpose.  Capital Leasing Solutions may disclose to any other interested parties our experience with this account.  Applicant agrees to inform Capital Leasing Solutions immediately of any matter which will cause any significant change in Applicant’s financial condition. Applicant understands that Capital Leasing Solutions will retain this application whether or not credit is granted.  Capital Leasing Solutions may share this application or information contained in or related to it with affiliates of Capital Leasing Solutions to determine Applicant’s eligibility for other products or services offered by Capital Leasing Solutions’ affiliates, unless you write to Capital Leasing Solutions, at 813 Southeast 2nd Court, Fort Lauderdale, FL 33301 to advise that you do not want this information shared.