Equipment Sale-Leaseback
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" indicates required fields
Business Information
Amount Requested for Sale-LeaseBack
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-- Choose an Option --
$100,000-$300,000
$300,000-$500,000
$500000 - $1,000,000
$1,000,000 - $3,000,000
$3,000,000 - $5,000,000
$5,000,000 - $10,000,000
$10,000,000 +
Legal Business Name
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Copy of current business license required
Business Telephone
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Name of CPA or Auditor / Phone Number
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Name or company name of financial advisor
Business Description
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A brief overview of your company services or products provided.
Name of Primary Bank
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Please attach a voided check with the document uploads
Primary Business Address / Corporate Office
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Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Years in Business
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-- Choose an Option --
1 - 2 Years
3 - 4 Years
5 - 6 Years
7 - 8 Years
9 - 10 Years
10+ Years
Annual Revenue
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-- Choose an Option --
$250,000 - $500,000
$500,000 to $1,000,000
$1,000,000 - $2,000,000
$2,000,000 - $5,000,000
$5,000,000 - $7,500,000
$7,500,000 - $10,000,000
$10,000,000 - $30,000,000
$30,000,000+
Business Structure
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-- Choose an Option --
Corporation
LLC
Partnership
Sole Proprietorship
LLP
Non-Profit
Partnership
Company Website
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If Your Company Doesn't Have a Website - Don't Bother Filling Out This form
Audited Financials?
yes
no
Reviewed Only
Don't Know
Federal Tax ID #
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Trade Reference / Contact Information
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Do You Have Current Appraisal
yes
no
Third Choice
Use of Loan proceeds
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Equipment Details
Provide Details on Each Piece of Equipment (Make, Model, Year, Etc.) *Attach Original invoices or images of equipment below
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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
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How will this equipment be used to grow the business, expand capacity or replace older or failing equipment?
Condition of Equipment When Acquired
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-- Choose an Option --
New
Used
Refurbished
All used equipment will require pictures of the equipment and a condition report or appraisal
Original Vendor / Seller of Your Equipment
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Do You Have Maintenance Records Available?
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Where Will Equipment Be Located
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Required Attachments
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Drop files here or
Select files
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
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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
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Name/Title
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Date
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Month
Day
Year
Owner Information
Name
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First
Last
SSN #
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% Ownership (For 15% Owners )
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Estimated FICO Score
-- Choose an Option --
Below 600
601-650
651-700
701 - 730
731 - 800
Unsure
Cell Phone #
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Email Address
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Enter Email
Confirm Email
Date of Birth
*
Month
Day
Year
Address
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Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Own or Rent
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-- Choose an Option --
Own
Rent
Other
Do You Have a Current Financial Statement?
yes
no
Employment Status
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-- Choose an Option --
Employed by Applicant Company
Employed Elsewhere
Retired
Owner #2
Add Owner #2 Information
Owner 2 Information
Name
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First
Last
Social Security Number
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% Ownership (For 15% Owners )
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Estimated FICO Score
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-- Choose an Option --
Below 600
601 - 650
651 - 700
701 - 730
731 - 800
Unsure
Cell Phone #
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Email Address
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Enter Email
Confirm Email
Title
Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Own or Rent
Own
Rent
Other
Do You Have a Current Financial Statement
Yes
No
Employment Status
Employed by Applicant Company
Employed Elsewhere
Retired
Patriot Act Compliance Information
Applicants Drivers License Number
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Issuing State
-- Choose an Option --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Expiration Date
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Month
Day
Year
Consent
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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
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Date
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Month
Day
Year
Signature of Co-Applicant
Date
Month
Day
Year
Name
This field is for validation purposes and should be left unchanged.
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