Please complete as much of this form as possible before submitting the application. Items in bold are required. LESSEE (COMPANY) INFORMATION Legal Name of Business: Phone Number: Fax Number: Contact Person: Title: Email Address: Company Address: City: State/Province: Zip/Postal Code: Federal Tax ID: Type of Business: Corporation   LLC   Partnership   Proprietorship Years in Business: Under Current Ownership: Number of Employees: Business Industry: OWNER INFORMATION FIRST PRINCIPAL OR GUARANTOR Name: Professional Title: Home Phone: Ownership %: Home Street Address: City: State/Province: Zip/Postal Code: SECOND PRINCIPAL OR GUARANTOR Name: Professional Title: Home Phone: Ownership %: Home Street Address: City: State/Province: Zip/Postal Code: THIRD PRINCIPAL OR GUARANTOR Name: Professional Title: Home Phone: Ownership %: Home Street Address: City: State/Province: Zip/Postal Code: VENDOR / EQUIPMENT INFORMATION Please fax any additional equipment and/or vendor information to 916-988-3931. Vendor Name: Contact: Telephone: Street Address: City: State/Province: Zip/Postal Code: Equipment Installation Location: (if different than Company Address above) Requested Terms: Expected Delivery Date: New/Used: NewUsed Quantity: Equipment Description: Selling Price: NewUsed NewUsed Total amount to be leased including shipping and installation: BANK REFERENCES Bank Name: Branch: Telephone: Contact: Account #: TRADE REFERENCES Company Name: Telephone: Contact: Account #: LEASE/LOAN REFERENCES Company Name: Telephone: Contact: Account #: Once you have submitted this form by clicking on the button below, you will be directed to the Credit Release page. Your application cannot be processed until you PRINT, FILL-OUT, SIGN and FAX the Credit Release to Leasource at 916-988-3931.

Please click here if you would rather use our Faxable Commercial Lease Application.