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Lease Application

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Lease Application

The Lease Application allows us to verify your credit and approve your lease request.

Please complete your application and click "submit" or print out the application and fax it to:
866-619-4738 (Nationwide -- Toll-free)
716-926-2018 (Western New York)

Company Information

Company (Legal Name)
Contact
Contact Title
Street Address
City
State
Zip
County

DBA
Fed ID#
Telephone
800#
Fax
Email
Website

Business /Leasing Information

Nature of Business :
Type of Business
Date Started
Time under current Management

Annual Sales
Annual Business Net Income

Principals

Principal 1

Title

Ownership %

Social Security #

Annual Income

Address

City

State

Zip

Home Phone

Principal 2

Title

Ownership %

Social Security #

Annual Income

Address

City

State

Zip

Home Phone

Bank and Trades

Bank Reference
Account Number
Phone
Contact

Trade1
Account Number
Phone
Contact

Trade2
Account Number
Phone
Contact

Equipment Information

Type of Equipment To Lease
Approximate Cost
Lease Term Requested
Vendor
Phone
Contact

By typing in your name,dating and clicking the "submit" button or by undersigning and faxing the application to 866-619-4738 (Nationwide -- Toll-free) or 716-926-2018 (Western New York), you are stating that you are either the principal party of the credit applicant or a personal guarantor of its obligation, and are authorizing Evans National Leasing, Inc. (and any assignee or potential assignee thereof) to review his/her personal credit profile from a national credit bureau and authorizes all requested bank and trade information to be released via telephone or fax to Evans National Leasing, Inc.