Business
Check appropriate business structure: Proprietorship
Partnership
Corporation(C-Corp)
Corporation(S-Corp)
Business Name/Lessee:
Contact:
Email:
Telephone:  .  . 
Address(Street):
City:
State:
County:
Zip Code:
Nature of Business(or SIC Code):
Approximate Annual Revenue:
Fax:  .  . 
Age of Business:
Federal Tax No.:
Location of Equipment (*If different from above):
Address(Street):
City:
State:
County:
Zip Code:
Ownership
Principal's Name:
Title:
% Ownership:
Home Phone No:  .  . 
Social Security No:
Address(Street):
City:
State:
Zip Code:
Choose one: Own    Rent
Principal's Name:
Title:
% Ownership:
Home Phone No:  .  . 
Social Security No:
Address(Street):
City:
State:
Zip Code:
Choose one: Own    Rent
Bank
Bank:
Contact:
Fax:  .  . 
Telephone:  .  . 
Account under Name of:
Checking Account No.:
Loan Account #:
Current Balance:
Bank:
Contact:
Fax:  .  . 
Telephone:  .  . 
Account Under Name Of:
Checking Account No.:
Loan Account #:
Current Balance:
Credit
Company Name: Account No.: Telephone No.: Contact Person:
 .  . 
 .  . 
 .  . 
Equipment
Vendor:
Contact:
Address(Street):
City:
State:
Zip Code:
Telephone:  .  . 
Equipment To Be Leased:
Fax:  .  . 
Cost of Equipment:
Terms of Lease:
Rate/Monthly Payment:
Deposit Received:

I hereby authorize OFE Business Credit, Inc or any credit bureau or other investigative agency employed by OFE Business Credit, Inc. to investigate the references herein listed or statements or other data obtained from me or from any other person pertaining to my credit and financial responsibility. I hereby warrant that I have requisite authority to engage in and negotiate this financing application.