Name: Consolidated Capital Company
Address: N53 W24880 S. Corporate Circle Suite 5, Sussex, WI, 53089-4386, US
Telephone: 262-225-1122

p: (262)-225-1122
e: info@conscap.net

Vendor*
Email*
Type of Equipment*
Sales Contact
Cost of Equipment*
Phone*
Lease Term*
Please Attach Equipment Quote(s) if available
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LESSEE CREDIT INFORMATION
Business and/or Personal Financial Statements may be necessary depending upon years established, credit and total investment.
Lessee Company Name*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Type of Business*
Fax
Equipment Location*
Mobile Phone
Email*
Contact*
Federal ID Number*
COMPANY/OWNERSHIP INFORMATION
Business Started*
MM slash DD slash YYYY
President*
Secretary
Present Owners Since*
MM slash DD slash YYYY
Vice President*
Treasurer
Name
First Last
Principle*
Social Security Number*
Home Phone*
Home Address
Street Address Address Line 2 City State ZIP Code
Principle
Social Security Number
Home Phone
Home Address
Street Address Address Line 2 City State ZIP Code
Net Worth*
Business Organization*
- Proprietorship
- Partnership
- Corporation
BANK INFORMATION
Current Bank*
Account # or Loan #*
Bank Officer*
Phone*
TRADE REFERENCES
Company Name*
Contact*
Phone*
Company Name*
Contact*
Phone*
Signature*
Lessee/borrower represents and warrants that all credit and financial information submitted to lessor/lender herewith, or at any other time is true and correct. I hereby authorize our banks, trade references, and financial institutions the right to release credit information and lessor/lender to run any consumer credit bureau reports or other such reports.
Date*
MM slash DD slash YYYY

Application

LESSEE CREDIT INFORMATION