Lease Application

Download application (.pdf) to print and fax

Fill out this form to complete our online lease application:

LESSEE COMPANY INFORMATION
       
*Full Company Name:
    
*Company Address:
   
*City:
Country:
*State:
*Zip:
       
*Location of Equipment:
*Years in Business:
*Telephone Number:
*Est. Annual Income:
*Fax Number:
*# Employees:
*Nature of Business:
*Fed Tax ID #:
*Legal Structure:
   
 
PERSONAL INFORMATION ON OFFICERS, PARTNERS OR GUARANTORS
       
*Name:
*Title:
*% Ownership:
*Social Sec. #:
*Home Address:
 


*City:
*State:
   
*Zip:
Name:
Title:
% Ownership:
Social Sec. #:
Home Address:
 

Own
Rent
City:
State:
 Zip:
       
EQUIPMENT INFORMATION
       
*Total Amount Requested:
*Term:
*Deposit:
*Equipment Vendor Name:
*Vendor Contact:
*Phone:
*Fax:
*Address:
*Equipment Desciption:
   
       
COMPANY BANK REFERENCES - TWO YEAR HISTORY
       
*Name of Bank/Branch:
*How Long:
*Checking Acct #:
*Loan Acct #:
*Telephone Number:
*Contact:
*Fax Number:
   
       
*Name of Bank/Branch:
*How Long:
*Cking Acct #:
*Loan Acct #:
*Telephone Number:
*Contact:
*Fax Number:
   
       
COMPANY TRADE/SUPPLIER REFRENCES - TWO YEAR HISTORY
       
*Name of Trade/Supplier:
*City/State:
       
*Name of Trade/Supplier:
*City/State:
       
*Name of Trade/Supplier:
*City/State:
       
LANDLORD AND INSURANCE INFORMATION
       
*Landlord:
*City/State:
*Telephone Number:
*Contract:
       
*Insurance:
*City/State:
*Telephone Number:
*Contract:
       

I/we hereby authorize you to whom this application is made, or your agents, to investigate my/our credit worthiness. I/we hereby authorize my/our creditors to release all credit information to CapitalPartners Leasing, Inc. or its agents. I/we represent and warrant that the information submitted herein is true and correct.

(* denotes a required field)

*Your Name:
  
*Your Email:
  by submitting you agree to the statement above.