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ABI Advantage Leasing Application

* = required field

Company Information:
Legal Company Name:		*
Address:		*
City / State / Zip		*
Authorized Signer/ Title:		*
Company Telephone:		*

Business Structure:
Number of Years in Business:		*
Equipment Cost ($) or approx. value		*
(We will refinance your present equipment or new equipment)

Personal Information:
Borrower's Name:		*
SSN:		*
Home Address:		*
City:		*
State:		*
Zip:		*

Co-borrower's Information (if applicable):
Co-borrower's Name:
SSN:
Home Address:
City:
State:
Zip:

Trade References:
Name of Supplier:
City / State:
Telephone:
Contact Person:

Equipment Description:
Please briefly describe the equipment you wish to lease. (New or presently possessed. We finance both!)


Declaration:
The above information, together with any accompanying financial statements, schedules, or other materials as required is submitted (we will call you if additional documentation is necessary) for the stated purpose of obtaining funding and is warranted to be true, correct and complete. ABI Advantage Funding will contact you regarding your application within 24-48 hours. Thank you for choosing the ABI Advantage!
Applicant Name:
Title:
Date:
E-Mail Address:		*

Electronic Signature:

By typing your name in this field electronically, it constitutes a signature and you are signing that the above information is true and correct and you are the person above and you are granting permission for a credit check on the parties above. If co-signed, both names need to be signed in the Signature box above.

This is a secure form. Your information is encrypted and safe and goes to our underwriters. Thank you for choosing to take the ABI Advantage! path to a positive cash flow business!

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