Business Name:
Business Address:
City, State, Zip:
Business Telephone:

Corporation Sole Proprietor Partnership

Number of Years in Business:
Type of Business:
Lease Amount (Exclude Tax):
Monthly term:
Rate Factor:
Monthly Payment:
Purchase Option:

Officer(s) Information (owners)
Name:
Address:
Title:
Social Security Number:

Equipment Description

Bank Information (at least 2 years old)
Name:
Contact:
Phone:
Type Account:
Acct. Number:
Date Opened:

Trade Information (credit references)
Name:
Contact:
Phone:
Name:
Contact:
Phone:
Name:
Contact:
Phone:

Vendor Information (supplier of equipment)
Name:
Contact:
Address:
Phone:

Additional Information

Authorization to Obtain Consumer Credit Report
By signing below, each undersigned individual(s), who is either a principal of the credit applicant listed below or a personal guarantor of its obligations, provides written instruction to Ryan Capital Leasing Corporation or its designee (and any assignee or potential assignee thereof) authorizing review of his or her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the application of the credit applicant and subsequently for the purposes of update, renewal or extension of such credit and for reviewing or collecting the resulting account.  A photostatic or facsimile copy of this authorization shall be valid as the original. 
I hereby authorize the release of credit information to
Ryan Capital Leasing Corporation for the
purpose of verifying my credit.

Print Name: _________________________________________
Date: _________________________________________

Thanks for your business