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Leasing Unlimited Group, LLC

04/29/2003

Menu Lease Tip Structuring your lease as a "True Lease" provides the most tax benefits. God Bless America		Please fill in the information blanks below. *The fields with () are required. In order to properly process your application, all of the () fields must be filled in. Thank you.* For more information, or if you would rather fill out the "print-and-fax" form, download it here and fax to (866) 295-6472. Company Information *Legal Company Name: Pre-Approval Requested? Address:* *Address 2: City:* *State: Zip Code:* *County: Telephone:* *Fax: Contact Name:* *e-mail: Equipment Location:* *Business Type: Years in Business:* *Nature of Business: Bank Information Bank Name:* *Contact Person: Account #:* *Telephone: Fax:* Principal Information *Owner's Name: Ownership Percentage: SSN:* *Home Phone: Home Address:* *City: State:* *Zip Code: Principal #2 Information Owner's Name:* Ownership Percentage: *SSN: Home Phone:* *Home Address: City:* *State: Zip Code:* Trade Information *Trade Name: Contact Person:* *Account #: Telephone:* *Fax: Trade #2 Information Trade Name:* *Contact Person: Account #:* *Telephone: Fax:* Vendor Information *Vendor's Name: Address:* *City: State:* *Zip Code: Telephone:* *Contact/Salesperson: Equipment Description:* *New or Used: Equipment Cost:* By submitting this application, I hereby certify that the information contained in this lease application is true and accurate and I hereby authorize our banks, trade references, and financial institutions the right to release credit information.