Application – Freedom Fin.leasing corpo

BUSINESS INFORMATION

Business Legal Name:

Business Address:

City/County:

State:

Zip:

Federal ID Number:

Business Phone Number:

Business Fax Number:

State of Incorporation:

Type Of Business:

Time In Business Under Current Ownership:

Type of Ownership:

BANK/CHECKING & SAVINGS 1

Bank:

Phone:

Fax:

Officer:

How Long:

Account #:

Type of Ownership:

BANK/CHECKING & SAVINGS 2

Bank:

Phone:

Fax:

Officer:

How Long:

Account #:

Type of Ownership:

EQUIPMENT LOANS/LEASES

Firm Name:

Phone:

Fax:

Account #:

High Credit:

How Long:

TRADE REFERENCE 1

Firm Name:

Phone:

Fax:

Account #:

High Credit:

How Long:

TRADE REFERENCE 2

Firm Name:

Phone:

Fax:

Account #:

High Credit:

How Long:

PRINCIPAL INFORMATION 1

Name (First-Middle-Last) Please Print:

Date of Birth:

Title:

% Ownership:

Present Address:

City/County:

State:

Zip:

Home Phone Number:

Social Security Number:

PRINCIPAL INFORMATION 2

Other Owner/Guarantor

Date of Birth:

Title:

% Ownership:

Present Address:

City/County:

State:

Zip:

Home Phone Number:

Social Security Number:

EQUIPMENT INFORMATION

Vendor Name:

Vendor phone Number:

Equipment Description:

Equipment Cost:

Include Cost:

Where Will Equipment Be Located:

Term Requested:

Purchase Option:

Comments:

My checking this box will serve as authorization to release information regarding my account(s) to Freedom Financial Leasing Corporation.

Print Form

application form

BUSINESS INFORMATION

BANK/CHECKING & SAVINGS 1

BANK/CHECKING & SAVINGS 2

EQUIPMENT LOANS/LEASES

TRADE REFERENCE 1

TRADE REFERENCE 2

PRINCIPAL INFORMATION 1

PRINCIPAL INFORMATION 2

EQUIPMENT INFORMATION

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LEASING INFORMATION

INDUSTRIES