BUSINESS INFORMATION * Required *Company Name: *Business Phone: *Business Fax: *Business Address1: Business Address2: *City: *State: *Zip: *Federal Tax ID #: *Date Started: *Type of Corporate: S Corp C Corp Partnership Sole Proprietor LLC Other Alternate Phone #: OWNER 1 * Required *Full Legal Name: First Name: M.I.: Last Name: Your E-mail Address: *Title: *Ownership %: *SSN Number: *Home Phone: *Cell Phone: Email Address: *Home Address1: Home Address2: *City: *State: *Zip: *Has any Owner/Officer filed a Bankruptcy in the last 5 years? YesNo OWNER 2 Full Legal Name: First Name: M.I.: Last Name: Your E-mail Address: Title: Ownership %: SSN Number: Home Phone: Cell Phone: Email Address: Home Address1: Home Address2: City: State: Zip: DESCRIBE YOUR FINANCING NEEDS * Required *Please be specific. (e.g. If applying for equipment financing, include the Year, make, model, miles, hours, etc.) *Terms Desired 24 Months 36 Months 48 Months 60 Months Other *Purchase Price($): *Down Payment Amt($): *Vendor Name(s): *Vendor Phone: *Vendor Contact: BANKING INFORMATION Name of Bank: Contact: Bank Phone Number: Address: City: State: Zip: First Account #: Acct Type: Checking Savings Other Second Account #: Acct Type: Checking Savings Other TRADE REFERENCES * Required *Please provide up to 3 trade references, including the company name, contact, phone number and high credit limit. I/ we hereby authorize you to whom this application is made, or your agents, to investigate my/our credit worthiness and will provide financial statements, tax returns, etc., as you deem necessary. I/ we agree that the advance payments under the lease are not refundable unless the lessor rejects the application. By the execution of the lease agreement, I/ we warrant that the information submitted herein is true and correct and hereby authorize references contained herein to release any necessary information. Further, I/ we warrant it is understood that lessor reserves the right to reverse any credit decision if the information contained herein is found to be incorrect, and I/ we will indemnify lessor for any and all costs incurred with this application for credit including any cost incurred in the placement or reservation of the intended leased equipment based on the information contained herein. Submitting this application is equivalent to a signature. Submitting this application is equivalent to a signature. Name of person submitting application:	Or call us at 888-846-8268
	551 Windsor Drive. Suite 100. Palisades Park, NJ 07650. Phone: 888-846-8268 Fax: 201.676.3047 © 2007 Ovant Financial Group LLC. All rights reserved.