MED Client Application

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.