Secure Commercial Lease Application

Company Information

Business Name/DBA* Primary Contact
Address City/State/Zip
Email Address* Phone Number*
Fax Number Business Type
Tax ID Number Time in Business
 

Principles Information

Name Title
Social Security # % Ownership
Home Address City/State/Zip
Phone Number Rent/Own
 
Name Title
Social Security # % Ownership
Home Address City/State/Zip
Phone Number Rent/Own
 

Company Bank References (Personal account is okay if Sole Prop.)

Bank/Institution Name Bank Phone
Account Type Account Number
 

Lease/Loan Reference

Institution Name Phone Number
Amount Financed Account Number
 

Equipment Details

Equipment Description Estimated Cost
Equipment Vendor Vendor Contact
Vendor Phone New/Used
 

Application Consent

The above information, along with any financial statements, schedules, or other materials is submitted for the purpose of obtaining credit and is warranted to be true, correct, and complete. The undersigned hereby warrants that any individual identified above who is either a principle, personal guarantor, or a sole proprietor of the credit applicant, recognizing that his or her individual credit may be a factor in the evaluation of the credit history of the applicant, has provided his/her written authorization for inquiry into their credit worthiness, included but limited to a consumer credit report and shall hold Highland Financial Group and its assignees harmless from the same.

Highland Financial Group is hereby authorized to investigate (directly or through an agent or nominee) you/their credit and financial responsibility. You understand that such investigation may include seeking information as to the background, credit, and financial responsibility of your officers or principles (or any of them).


*Name *Date   
* Required Field

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