Equipment Lease Commercial Application Commercial Equipment Lease Financing Application Use this form to apply for a business equipment lease from amounts of $2000.00 to $75,000.00. If you have a sale's invoice, you may upload a copy at the bottom of the application form. Please contact us for leasing "Over the Road" vehicles or equipment purchases of higher than $75,000.00. Legal Business Name* DBA Name Business Street Address* City State Postal / Zip Code Business Phone* Area Code - Phone Number Secondary Phone Area Code - Phone Number Time in business (years/months)* Business Type*Please Select Business TypeCorporationLLCPartnershipSole Proprietorship Billing Address (if different) City State Postal / Zip Code Federal ID# * Business Contact*FirstLast Business Contact Email Address* Confirm Business Email*Equipment Information Equipment Type*Please Select Equipment TypeATMAutomotiveCleaningCoffeeComputerConstructionCopierDronesEmbroideryEnergy ManagementEngravingEvent Decor and EquipmentFitnessFood ServiceFurnitureGeneratorsGroomingHVACHealthcareLandscapeLaundryLivestockMaterials HandlingMachine Shop EquipmentMortuary EquipmentMultimediaOfficeOther/General EquipmentPhotographyPoint of Sales SystemsPotteryPrintingRecreationalRefrigerationSalonSchool and Daycare EquipmentSecurity/CCTVSignSoftwareSolar panelsTelecommunicatiionsToolsVendingWater QualityWoodworking Equipment Description: (Quantity, Manufacture, Model, Serial #) * Equipment Condition*NewUsedReconditioned Total Equipment Cost* Dealer/Vendor Name Dealer/Vendor Phone # Area Code - Phone Number SalespersonBusiness Owner(s) Information Business Owner/Guarantor 1 Full Name* Title* % of ownership* Social Security #* Date of Birth*01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 2018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901year Home Street Address* City State Postal / Zip Code Home Phone* Area Code - Phone Number Secondary Phone # Area Code - Phone Number Guarantor 2 Full Name (must be part owner) Guarantor 2 Title Guarantor 2 % of ownership Guarantor 2 Social Security # Guarantor 2 Date of Birth01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 2018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901year Guarantor 2 Home Street Address City State Postal / Zip Code Guarantor 2 Home Phone Area Code - Phone Number Guarantor 2 Secondary Phone # Area Code - Phone Number Please Authorize:* The undersigned applies for the lease indicated in this application. Everything stated in this application is correct. Assured Capital Funding, LLC may retain the application whether or not the lease is approved. Assured Capital Funding, LLC and its Authorized Affiliates are authorized to check my credit and employment history for the purposes of determining my credit worthiness at the time of my application or thereafter in connection with the same transaction or extension of credit and for the further purpose of reviewing the account. I Agree to the terms above.* Authorized Signature * Date* I Agree to adopt this typed representation of my name as my signature*Send a copy of this message to yourself Upload sale's invoice if you have one. SubmitReset