A+ ICE MACHINE & RESTAURANT EQUIPMENT COMPANY LEASE APPLICATION

BUSINESS INFORMATION  

Business Principal Officers Address 
Street Address    
City State Zip Code
Phone Number Ext. Fax Number E-Mail Address
Type of Business   Time in Business Years  Months
Corporation         LLC Partnership Sole Propietorship
Fed Tax ID # Social Security  Resale Certificate
Tax Exempt ? Yes  No Other Locations ?  Yes  No Other Locations Addresses --- fax to us

ORGANIZATION PRINCIPALS

Principal #1 Name Title
Phone  
Principal #2 Name Title
Phone  
Principal #3 Name Title
Phone  

BANK INFORMATION

Bank Name Bank Phone NumberExtension
Business Checking Account Number Bank Contact Person Phone Number

TRADES INFORMATION

Trade Name Phone Number Contact Person
Account Number Account Type Open COD Only numbers in "Account Number" please
Trade Name Phone Number Contact Person
Account Number Account Type Open COD Only numbers in "Account Number" please
Trade Name Phone Number Contact Person
Account Number Account Type Open COD Only numbers in "Account Number" please

EQUIPMENT & VENDOR INFORMATION

Vendor Name Vendor Phone Vendor Fax Number
Street Address City State Zip Code
Equipment Equipment Cost Term of Lease 24 36 48 60 Mo.
Purchase Option --- Fair Market Value $ 1.00 Buyout 10% PUT

THE FOLLOWING IS THE EQUIPMENT I WISH TO LEASE.....

Please give a complete description of the equipment you are submitting this lease application for. Be specific with Manufacturers Name, Types of Equipment, Model Numbers, Quantity of each item etc.

By submitting this application, the individual applicant(s) who is/are either a principal(s) of the credit applicant listed above or a personal guarantor of its obligations. provides written instruction to finance company or its designees, assignees and/or successor(s)-in-interest authorizing review of his/her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purpose of update, renewal or collecting the resulting account. A copy of this authorization shall be valid as the original. In addition to authorizing review applicants credit profile from any normal credit bureau, the applicant also authorizes his/her financial institutions and creditors to release credit information required by finance company or its designee (and any assignee or potential assignee there-of)

This is an internet application and no signature is required for the pursuit of the above submitted information.