Online Credit Application
 
 

Business Information

 


Email Address:

Full Legal Name (Include DBA if Applicable):

Tax Identification #:

Billing Street Address:

City/County/State/Zip:

Equipment Location (If Different from Billing Address):

City/County/State/Zip:

Contact Name and Title:

Phone Number:

Business Description:

"S" Corporation
Corporation
Proprietorship
Partnership
LLC
LLP

Years in Business:

Name  (Personal Guarantor/Principal/Partner/Officer):

Social Security Number:

Home Street Address (Personal Guarantor/Principal/Partner/Officer):

City/County/State/Zip:

Phone Number:

Name2 (if applicable) (Personal Guarantor/Principal/Partner/Officer):

Social Security Number:

Home Street Address (Personal Guarantor/Principal/Partner/Officer):

City/County/State/Zip:

Phone Number:

 

Lease Term:

12 Mo. Lease
24 Mo. Lease
36 Mo. Lease
48 Mo. Lease
60 Mo. Lease
 
 

Equipment Information


Total Estimated Equipment Cash Price:

# of Advance Payments:

Total Estimated Lease Payment:

Equipment Description:

Equipment Description (Mfgr/Model):

Supplier Name(s):

Contact Name(s):

Phone Number:

End of Lease Options:

FMV
Fixed %
Fixed $  

 
 

Business Bank Reference


Business Bank Reference Name:

Checking/Loan Account #:

Phone Number:

Address (City/State):

Account/Loan Officer:

 
 

Personal Bank Reference


Personal Bank Reference Name:

Checking/Loan Account #:

Phone Number:

Address (City/State):

Account/Loan Officer:

 
 

Trade Reference


Trade References & Business Loans (Name/Phone Number/Contact)

1:

2:

3:

 
Business Purpose
The undersigned represents that all information provided with this Application is true and correct and hereby authorizes Equipment Leasing Options to obtain from third parties information Lessor deems necessary to arrive at a decision regarding this Application. Applicant certifies to ELO that it is applying for credit for business purposes, and not for personal, family use.
 
 

Credit Information Release


By signing below, the undersigned individual as principal of and/or guarantor for the applicant authorizes ELO, its designee, assigns, or potential assigns, to review his/her personal credit profile provided by national credit bureaus in considering this Application and for the purpose of the update, renewal, or extension of credit to the Applicant or the collection of any resultant accounts. Fax or copy of this authorization valid as original.

Type your full name here:

Date: