Equipment Sale-Leaseback

"*" indicates required fields

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: 64 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

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*

Signature of Applicant*

Date*

Signature of Co-Applicant

Date

Name

This field is for validation purposes and should be left unchanged.