Lease Application
Please fill out the following and submit to Thielking Leasing, Inc.
Fax 515-327-5031 • Phone 515-327-5069
COMPANY INFORMATION
Full Legal Name of Business:
Billing Address (Street):
City:
State:
Zip:
County:
Contact Title:
Phone:
Fax:
E-Mail:
Federal Tax ID or Social Security Number:___________________________________________
Type of Business:
Date Business Established:
Number of Employees:
COMPANY STRUCTURE
Please check one:
__CORPORATION __LLC __LLP __PROPRIETORSHIP __GENERAL PARTNERSHIP __GOVERNMENT __OTHER
All owners partners and shareholders must sign. Please attach a separate sheet if necessary. List names, titles, home addresses, home phones, SSN's and percentage of ownership of partners or shareholders.
RELEASE: I authorize Thielking Leasing, Inc. to make inquires as necessary to verify the accuracy of the statements made and to determine my credit-worthiness in conjunction with either obtaining credit or providing a guarantee. I also authorize those institutions listed as part of this application to release any information requested concerning our personal or business credit standing.
Signature and Position
:
Date
:
BANK REFERENCES
Bank #1
Account#_____________________________________________________
Phone:
Contact Person:
Name of Bank:
Equipment
Description:
Lease Terms (months):
Information
Supplier:
Phone:
Fax:
Location of Equipment:
Estimate Cost:
Fixed Purchase Price:
Other:
TRADE REFERENCES
Reference #1
Company Name:
Address:
Phone:
Contact:
Reference #2
Company Name:
Address:
Phone:
Contact:
COMPARABLE
Company Name:
CREDIT
Phone:
Account #______________________________________________________
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