$ Nutech Capital Resources $

Equipment Lease Application

First Name: Last Name: 
Company Name: D.B.A.:
Your Title/Position:
Business Addrs:
City: State: Zip:
Phone: Fax:
e-mail:
Business Structure: State No. of Owners/Partners:
Business started: Month Year
Federal Tax ID#
Bank References:
1. Bank: Ph: Contact: Acct #: Type:
2. Bank: Ph: Contact: Acct #: Type:
3. Bank: Ph: Contact: Acct #: Type:
Trade References:
1. Trade Ph: Contact: Acct.#:
2. Trade Ph: Contact: Acct.#:
3. Trade Ph: Contact: Acct.#:
* Trade Ph: Contact: Acct.#:
**Landlord Ph: Contact: Acct.#:
* Comparable Trade Reference
** Business Landlord
Personal Information for Principals or Guarantors:
#1: Title: % of ownership: Soc Security #:
#2: Title: % of ownership: Soc Security #:
#3: Title: % of ownership: Soc Security #:
Please Note: No personal credit checks will be run without prior written approval.
Equipment:
Vendor: Contact Person:
Address: Ph: Fax:
Equipment Description: New Used
Term: Advance$: Purchase Option$: Total Invoice$:
Questions, Requests, Comments:

When completed please click on the submit button below:

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Nutech Capital Resources | P. O. Box 305, Brownsville | California | 95919 | USA
Ph: 530-675-9151 | Fax: 530-675-9152 | e-mail: Richard@NutechCapital.com

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