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Business InformationType of Business* Corporation / LLC (2+ years in business) Sole Proprietorship / Partnership / New Business Name of Business* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Name* Business Phone*Email Address* Website Address Annual Sales* Number Employees* Years in Business* Federal Tax ID* Applicant InformationName* First Middle Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Cell Phone*Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Personal Residence*OwnRentCredit InformationHave you filed for bankruptcy in the last 10 years?* Yes No Do you have any judgements, child support, student loans or collection agency to report?* Yes No Please Explain*Personal Net Worth Statement - AssetsWhat you own in U.S. DollarsHome - Real Estate Other Real Estate Personal Net Worth Statement - LiabilitiesWhat you owe in U.S. DollarsPrimary Mortgage Second Mortgage Other Loans Dealer / Vendor Name and Equipment DetailsDealer / Vendor Name Dealer Contact Name Dealer PhoneDealer Email Description of EquipmentSelling Price (before Taxes) CurrencyUSDCDNDescription of EquipmentSelling Price (before Taxes) CurrencyUSDCDNSupporting DocumentsIf you have documents to submit, you may upload them here.Upload Documents Drop files here or Select files Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 100 MB, Max. files: 6. Submit ApplicationTerms and Conditions I/We certify the above information to be true and correct. I/We hereby authorizes CFC Leasing, and / or any of its designated underwriters, or an authorized Equifax Agent, to obtain, or exchange personal information in whatever manner it may deem satisfactory, all the credit information it requires, whatever the source, such source(s) being hereby authorized to provide such information. CONSENT TO PERSONAL INFORMATION SHARING. Lessee consents and authorizes Lessor and its agents, at any time to communicate with and disclose to third parties (including Credit Reporting Agencies, Credit Exchanges, Leasing Brokers and Credit Grantors) any of Lessee credit, financial and personal information that Lessor deems necessary to complete, service or enforce this Lease and Ancillary Agreements, including additions, modifications, updates or other related transactions, including but not limited to the Assignment, Sale or Securitization of this Lease. This clause survives the term or termination of this Lease. CREDIT INVESTIGATION. Lessee hereby authorizes Lessor to conduct financial and credit investigations of Lessee for the purposes of approval, maintenance and enforcement of this Lease, or any judgement obtained by Lessor as a result of any default hereunder, and to obtain any information required from any source to which it may apply, and each source is hereby authorized to provide such information to Lessor. This includes, but is not limited to, the Lessor obtaining information from any credit reporting agency, creditor of Lessee, or banking and other financial institution where Lessee may have credit or depository facilities. Lessor may obtain such information at any time before or during the Lease Term or after termination of the Lease in the event any monies remain owing to Lessor. WAIVER. The parties hereto agree that this Agreement and all documents related thereto be written in the English language.Review terms and conditions* I/We have read and understand and agree with the above terms and conditions. Are you human?NameThis field is for validation purposes and should be left unchanged.
