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Home YOU CAN USE THIS BANNER TO ADVERTISE A SPECIAL.  SUCH AS  HIGHSPEED VARIABLE PRINTING SYSTEMS, LIMITED OFFER CIJ-425 CONTINUOUS FLOW INK JET, PAYMENTS AS LOW AS $xxx PER MONTH..
 

You may wish to print this form and fax it 1.703.584.7106

If you need assistance completing this form please call 1.888.480.8532

LEASE APPLICANT BUSINESS INFORMATION
Company Legal Name:
DBA (If applicable)
Company Address:  
Telephone Number:

Fax Number:

Email Address:
City, State, Zip:  ,
Date of Incorporation: Federal Tax I.D. #:
Business Type: Sole Owner Partnership Corporation Other
BUSINESS BANK REFERENCES
Business Bank/Branch: Phone:
Account Number: Type: Checking Savings Money Market
Loans at this bank: Yes No     Date Opened:
Business Bank/Branch: Officer/Phone:
Account Number: Type: Checking Savings Money Market
Loans at this bank: Yes No     Date Opened:
LOAN & TRADE REFERENCES
Firm Name:   City:   State:
Contact:   Phone:
Firm Name:   City:   State:
Contact:   Phone:
PERSONAL INFORMATION ON OFFICERS, PARTNERS OR GUARANTORS
Owner 1 Name: Title:
SSN: Phone:
Home Address:
City, State, Zip: ,
Owner 2 Name: Title:
SSN: Phone:
Home Address:
City, State, Zip: ,

VENDOR & EQUIPMENT INFORMATION
Vendor Name: Contact:
Phone:  Fax:
Address:  
City, State, Zip ,  

Equipment

Description:

  
Is the Equipment
New or Used?		 Cost (without Tax):
Terms Requested: 2 Years 3 Years 4 Years 5 Years Special

Location of

Equipment:

By submitting this application, I, authorize Blue Water Leasing, Inc. and it's agents or assigns to investigate my/our credit worthiness, as you deem necessary. I/We hereby authorize my/our references and/or any Credit Bureaus to release my/our information. I/We warrant that the information submitted herein is true and correct.
Your Name:

: