Utility Fleet Finance Form

Company Information
Company Name
Mailing Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Signer
Title
Phone - (###) - ### ####
Email *
Nature of Business
Type of Business Sole Proprietorship Partnership Corporation LLC
Personal Information (Officers, Partners, Guarantors)
Name * Title First Last Suffix
Title
% Ownership
SSN
Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Home Phone * - (###) - ### ####
How Long
Name Title First Last Suffix
Title
% Ownership
SSN
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Home Phone - (###) - ### ####
How Long
Company Bank References
Bank Name
Contact Officer
How Long
Phone - (###) - ### ####
Checking
Savings
Loan Acct
Bank Name
Contact Officer
How Long
Phone - (###) - ### ####
Checking
Savings
Loan Acct
Trade References of Two Years or More
Vendor Name
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Contact Person Title First Last Suffix
Phone - (###) - ### ####
Vendor Name
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Contact Person Title First Last Suffix
Phone - (###) - ### ####
Vendor Name
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Contact Person Title First Last Suffix
Phone - (###) - ### ####
Agreement
By signing below, the undersigned individual as principal of and/or guarantor for the applicant, authorizes Utility Fleet Sales, its designee, assigns or potential assigns, to review his/her personal credit profile provided by national credit bureaus in considering this Application and for the purpose of the update, renewal, or extension of credit to the Applicant or the collection of any resultant accounts. By the execution of the lease agreement, I/We warrant that the information submitted herein is true and correct and hereby authorize that any bank, lending institution, supplier, person or consumer reporting agency should comply and furnish any information Lessor deems necessary in connection with this Application. It is understood that the security deposit is not refundable unless the application is rejected by Lessor. 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.
Consent * I Agree
Name: *

Utility Fleet Finance Form

Utility Fleet Finance Form

Company Information

Personal Information (Officers, Partners, Guarantors)

Company Bank References

Trade References of Two Years or More

Agreement