Equipment Sale-Leaseback

Business Information

Amount Requested for Sale-LeaseBack*

Legal Business Name*

Copy of current business license required

Business Telephone*

Name of CPA or Auditor / Phone Number*

Name or company name of financial advisor

Business Description*

A brief overview of your company services or products provided.

Name of Primary Bank*

Please attach a voided check with the document uploads

Primary Business Address / Corporate Office*

Street Address City State ZIP Code

Years in Business*

Annual Revenue*

Business Structure*

Company Website*

Audited Financials?

Federal Tax ID #*

Trade Reference / Contact Information*

Do You Have Current Appraisal

Use of Loan proceeds*

Equipment Details

Provide Details on Each Piece of Equipment (Make, Model, Year, Etc.) *Attach Original invoices or images of equipment below*

If you have a long list of equipment please email to us proposals@equipmentleases.com * Private party transactions OK with special treatment

Purpose of This Equipment in the Business*

How will this equipment be used to grow the business, expand capacity or replace older or failing equipment?

Condition of Equipment When Acquired*

All used equipment will require pictures of the equipment and a condition report or appraisal

Original Vendor / Seller of Your Equipment*

Do You Have Maintenance Records Available?*

Where Will Equipment Be Located*

Required Attachments*

Drop files here or

Max. file size: 32 MB.

Scan and upload the following 1) 3-months bank statements, 2) Current Financial Statement 3) Interim Financials 4) Current Personal Financial Statement From Owners 5) Copy of Drivers License Front/Back 6) Original Invoices if Available 7) Copy of current business license 8) Pictures of the equipment or appraisal if used and 9) voided company check

Agreement*

I agree

I certify that the above information is true and correct and I authorize any bank, financial institution, or trade reference to release any information as may be requested by Equipment Leases Inc. and/or its assignees. I also hereby authorize Equipment Leases Inc. and/or its assignees to obtain other background or credit information and understand that by signing below you are providing “written instructions” to Equipment Leases under the Fair Credit Reporting Act, authorizing Equipment Leases Inc. to obtain information from your personal credit profile or other information from Equifax. You authorize Equipment Leases Inc. to obtain such information solely to conduct a pre-qualification for credit. TRUE AND CORRECT SIGNATURE/eSIGNATURE STATEMENT For the purpose of obtaining financing with any of the financial partners of Equipment Leases Inc. and otherwise procuring credit from time to time, I have honestly and willfully furnished you with the information requested. I agree to and will notify you immediately in writing of any materially unfavorable change in any financial condition that may have an effect on our ability to finance, and in the absence of such notice, or of a new and full written statement, this may be considered as a continuing statement and substantially correct; and it is hereby expressly agreed that upon application for further credit, this statement shall have the same force and effect as if delivered as an original statement of financial condition at the time such further credit is requested. AS THE SUBMITTER OF THIS APPLICATION, I HEREBY CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT REPRESENTATION OF THE ABOVE-MENTIONED INDIVIDUAL, FIRM OR CORPORATION NOW ON FILE WITH EQUIPMENT LEASES INC., AND THAT TO THE BEST OF MY KNOWELDGE AND BELIEF, THIS STATEMENT REFLECTS THE TRUE CONDITION OF THE BORROWER.

Signatures

Signature*

Name/Title*

Date*

Owner Information

Name*

First Last

SSN #*

% Ownership (For 15% Owners )*

Estimated FICO Score

Cell Phone #*

Email Address*

Enter Email Confirm Email

Date of Birth*

Address*

Street Address City State ZIP Code

Own or Rent*

Do You Have a Current Financial Statement?

Employment Status*

Owner #2

Add Owner #2 Information

Owner 2 Information

Name*

First Last

Social Security Number*

% Ownership (For 15% Owners )*

Estimated FICO Score*

Cell Phone #*

Email Address*

Enter Email Confirm Email

Title

Address*

Street Address City State ZIP Code

Own or Rent

Do You Have a Current Financial Statement

Employment Status

Patriot Act Compliance Information

Applicants Drivers License Number*

Issuing State

Expiration Date*

Consent*

I agree

I/We authorize Equipment Leases Inc. or it's assignees to verify the information provided on this form as it pertains to application for credit. I /We also understand that my personal credit report may be pulled for verification purposes.

Signature of Applicant*

Date*

Signature of Co-Applicant

Date