Equipment Application
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  • Please apply online below or download our application here and submit via fax.
  • EQUIPMENT LEASE / FINANCE APPLICATION

    COMPANY INFORMATION

    Company Name
    Federal Tax ID
    Company Address

    Street Address

    Address Line 2

    City
    State / Province / Region

    Postal / Zip Code
    Country
    Telephone No.

    ###    		-
    ###    		-
    ####
    Fax

    ###    		-
    ###    		-
    ####
    Nature of Business
    No. of Years in Business
    Type of Business
     Proprietorship 
     Partnership 
     LLC 
     Corporation 
     Non-Profit 

    PERSONAL INFORMATION Officers / Partners /
    Guarantors

    1) Name
    Title
    % Owned
    Monthly Household Income
    Home Address

    Street Address

    Address Line 2

    City
    State / Province / Region

    Postal / Zip Code
    Country
     Own 
     Rent 
    Social Security No.
    Date of Birth

    MM    		/
    DD    		/
    YYYY
    Personal Phone

    ###    		-
    ###    		-
    ####
    2) Name
    Title
    % Owned
    Monthly Household Income
    Home Address

    Street Address

    Address Line 2

    City
    State / Province / Region

    Postal / Zip Code
    Country
     Own 
     Rent 
    Social Security No.
    Date of Birth

    MM    		/
    DD    		/
    YYYY
    Personal Phone

    ###    		-
    ###    		-
    ####

    COMPANY BANK REFERENCE - Five-Year History

    1) Name of Bank / Branch
    How Long
    Telephone No.

    ###    		-
    ###    		-
    ####
    Checking Acct. No.
    Contact Officer
    2) Name of Bank / Branch
    How Long
    Telephone No.

    ###    		-
    ###    		-
    ####
    Checking Acct. No.
    Contact Officer

    LEASE / LOAN REFERENCES

    1) Lender
    Acct. No.
    Loan Amount
    Telephone No.

    ###    		-
    ###    		-
    ####
    Contact
    Amount Paid
    2)
    Acct. No.
    Loan Amount
    Telephone No.

    ###    		-
    ###    		-
    ####
    Contact
    Amount Paid

    TRADE REFERENCES

    1) Supplier
    Telephone No.

    ###    		-
    ###    		-
    ####
    Contact / Acct #
    2) Supplier
    Telephone No.

    ###    		-
    ###    		-
    ####
    Contact / Acct #
    3) Supplier
    Telephone No.

    ###    		-
    ###    		-
    ####
    Contact / Acct #

    EQUIPMENT / VENDOR INFORMATION

    Equipment Description
    Vendor Name
    Vendor Address

    Street Address

    Address Line 2

    City
    State / Province / Region

    Postal / Zip Code
    Country
    Telephone No.

    ###    		-
    ###    		-
    ####
    Equipment Cost $
     New 
     Used 
    Term
    Vendor Contact

    DECLARATION

    The undersigned individual, on behalf of themselves and all others listed on this application recognizing that their individual credit history may be a factor in the evaluation of the credit of the applicant, hereby consents to and authorizes Quail Equipment Leasing and any assignee, lender or funding service that may be utilized to obtain and use a consumer credit report on the undersigned, now and from time to time, as may be needed in the credit evaluation and review process and waives any right or claim they would otherwise have under Fair Credit Reporting Act in the absence of this continuing consent.

    To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth (for individuals), and other information that will allow us to identify you. We may also ask to see your driver's license (for individuals) or other identifying documents.
    Applicant Name*
     Consent and Authorize 
    Title*
    Primary email*
    Date*

    MM    		/
    DD    		/
    YYYY
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