Business Lease Application
Fast Application
Business Legal Name *
First Name *
Last Name *
Email *
Mobile Phone *
Business Phone *
Street Address *
Street Address 2
City *
State *
Zipcode *
Company Information
Business Entity Type
Nature of Business/ Industry
Years in Business Under Current Ownership
Federal ID#
Equipment/ Product
Equipment Brand
Equipment Description/ Model #
Estimated Sale Price($)
Term Length Requested (# of months)
Equipment Location (If different address)
Owners/ Stockholder Information
Number of Owners/ Stockholders *
Owner/ Stockholder 1: Name *
Owner/ Stockholder 1: Ownership % *
Owner/ Stockholder 1: Home Street Address *
Owner/ Stockholder 1: City *
Owner/ Stockholder 1: State *
Owner/ Stockholder 1: Zipcode *
Owner/ Stockholder 1: Social Security # *
Owner/ Stockholder 2: Name
Owner/ Stockholder 2: Ownership %
Owner/ Stockholder 2: Home Street Address
Owner/ Stockholder 2: City
Owner/ Stockholder 2: State
Owner/ Stockholder 2: Zipcode
Owner/ Stockholder 2: Social Security #
Owner/ Stockholder 3: Name
Owner/ Stockholder 3: Ownership %
Owner/ Stockholder 3: Home Street Address
Owner/ Stockholder 3: City
Owner/ Stockholder 3: State
Owner/ Stockholder 3: Zipcode
Owner/ Stockholder 3: Social Security #
Authorized Person Signing Financing/ Lease
Credit Authorization: I hereby authorize UniSource Capital or its assigns to make a complete credit check on our company and the principals to the same as individuals and to relate this information to others as necessary to secure credit approval. I also authorize the above references to release any information that may be requested by UniSource Capital. I certify this statement is true and accurate.
