Online Commercial Lease Application

Please complete as much of this form as possible before submitting the application. Items in bold are required.

LESSEE (COMPANY) INFORMATION
Legal Name of Business:	Phone Number:	Fax Number:

Contact Person:

Title:

Email Address:

Company Address:	City:	State/Province:	Zip/Postal Code:
	Federal Tax ID:

Type of Business: Corporation LLC Partnership Proprietorship

Years in
Business:

Under Current
Ownership:

Number of
Employees:

Business
Industry:

OWNER INFORMATION
FIRST PRINCIPAL OR GUARANTOR
Name:	Professional Title:	Home Phone:	Ownership %:
Home Street Address:	City:	State/Province:	Zip/Postal Code:

SECOND PRINCIPAL OR GUARANTOR
Name:	Professional Title:	Home Phone:	Ownership %:
Home Street Address:	City:	State/Province:	Zip/Postal Code:

THIRD PRINCIPAL OR GUARANTOR
Name:	Professional Title:	Home Phone:	Ownership %:

Home Street Address:

City:

State/Province:

Zip/Postal Code:

VENDOR / EQUIPMENT INFORMATION Please fax any additional equipment and/or vendor information to 916-988-3931.
Vendor Name:	Contact:	Telephone:

Street Address:

City:

State/Province:

Zip/Postal Code:

Equipment Installation Location:
(if different than Company Address above)

Requested
Terms:

Expected
Delivery Date:

New/Used:	Quantity:	Equipment Description:	Selling Price:


Total amount to be leased including shipping and installation:

BANK REFERENCES
Bank Name:	Branch:	Telephone:	Contact:	Account #:

TRADE REFERENCES
Company Name:	Telephone:	Contact:	Account #:

LEASE/LOAN REFERENCES
Company Name:	Telephone:	Contact:	Account #:

Once you have submitted this form by clicking on the button below, you will be directed to the Credit Release page. Your application cannot be processed until you PRINT, FILL-OUT, SIGN and FAX the Credit Release to Leasource at 916-988-3931.