APPLICAPRO, INC - Lease Application

on-line application

Lease Application

Welcome to our online Lease Application. Please fill in all fields requested below for accuracy in processing your credit application. We will notify you immediately as to the status of your credit application. You may also download and print our credit application in Acrobat Reader format and
fax it to us at toll free 1-800-571-9846.

Click Here To Download A Printable Application - Adobe Acrobat Format

Credit applications are processed Monday-Friday between the hours of 9:00AM-4:30PM.
Any credit applications submited after processing hours will be processed on the next business day.

Thank you, and we look forward to serving your equipment financing needs.

(* Denotes Required Fields)
Applications Will Not Be Processed Unless All Required Fields Marked * Are Completed

Business Information
Date:
Business Name: *
Business Address: *
Business Address 2:
Business City: *
Business State: *	Zip: *
Business Website:
Email Address: *
Business Phone: *
Business Fax:
Contact Name:
Years In Business: *
Nature of Business: *

Type of Business: *

Business Officers
President / Owner: *
% of Ownership: *
Home Address: *
Home City: *
Home State: *	Zip: *
Social Security: *
Home Phone:

VP / Partner:
% of Ownership:
VP Home Address:
VP City:
VP State:	Zip:
VP Social Security:
VP Home Phone:

Banking Information
Bank Name: *
Phone Number: *
Account Number: *
Banking Officer: *
Account Type: *

Trade References
Trade Reference: *
Trade Phone: *
Trade Reference 2: *
Trade Phone 2: *


Equipment Information
Equipment Vendor: *
Vendor Contact: *
Vendor Phone: *
Vendor Email Address: *
Equipment Selling Price: *
Equipment Description: *


Lease Terms
Lease Term Requested: *
Lease Buyout Option: *
By accepting below, I affirm my identity as either a principal of the applicant or a personal guarantor of its obligations, provides written instruction to EqLease or its assigns authorizing review of his/her personal credit bureau and authorizing applicant's bank and credit references to release credit information on applicant to EqLease and its assigns. Such authorization shall extend to obtaining a credit file in considering this application for reviewing or collecting the resulting account. A Photostat or Facsimile copy of this authorization shall be valid as the original. By accepting I affirm my identity as the individual identified in this application.

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