1. Applicant (exact name):
   
   
2. Headquarters:
   Address:
   Phone Number:
   Tax I.D. Number: (Required)
   
   
3. Type of Business: Year Started:
   Corp. Prop. Part. LLC Other
   
   
4. History and Nature of Business:
   
   
   
5. Owners/Guarantors: Title:
   Guaranty: Yes No Ownership: %
   Address: SS#:
   
   Owners/Guarantors: Title:
   Guaranty: Yes No Ownership: %
   Address: SS#:
   
   
6. Management & Experience:
   
   
   
7. Equipment: New Used - Date of Mfg.
   
   
   
8. Vendor/Dealer:
   Contact: Phone:
   Address:
   
   
9. Insurance Agent:
   Address:
   Phone: Contact:
   
   
10. Loan/Lease: Type & Purpose:
    
    
    
11. Financing Structure:

    Total Equipment Cost:	$
    Down Payment:	$

    Total Amount to Finance: $ for Months @	$
    Residential:	$

    Loan

    TRAC

    $1.00 Buy-out

    Fair Market Value

    
    
12. Bank References - Include Account #'s for all:
    

    1.	Name:	Account #:
    	Phone:	Officer/Contact:
    	Address:

    2.	Name:	Account #:
    	Phone:	Officer/Contact:
    	Address:

    
    
13. Finance Company Reference:
    

    1.	Name:	Phone:
    	Address:	Contact:

    2.	Name:	Phone:
    	Address:	Contact:

    3.	Name:	Phone:
    	Address:	Contact:

    
    
14. Trade References:
    

    1.	Name:	Phone:
    	Address:	Contact:

    2.	Name:	Phone:
    	Address:	Contact:

    3.	Name:	Phone:
    	Address:	Contact:

By signing below, the undersigned principle of credit application or a personal guarantor authorizes Capital Funding, Inc and its affiliates to review of his/her personal credit profile or such information as may be required concerning the above statements within the framework of the fair credit reporting act & warrants that the credit information and all financial statements submitted by applicant to lessor are true, correct & complete.  Applicant understands that lessor is relying on this lease application and financial statement submitted by applicant in making its decision whether to enter into a lease agreement, updates, renewals, or extension of such credit.  A Photostat or facsimile copy of this authorization shall be valid as the original.  This Application does not obligate the lessor or the applicant to enter onto a lease agreement.

THIS APPLICATION DOES NOT OBLIGATE THE LESSOR OR APPLICANT TO ENTER INTO A LEASE AGREEMENT