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Home Why Lease? Available Programs Vendor Programs Common Q&A Section 179 About
 
 
Corporate Information

Company
DBA Name
Address
City
State
Zip
Company Phone
Contact name
Contact Cell Phone
Type of Company
Date Established
Type of Business
Fed Tax ID #
Email Address

Vendor Information

Equipment Supplier
Address
City
State
Zip
Contact Phone
Sales Rep
   

Equipment Information

Equipment Cost
Lease Term
Purchase Option 10%
  $1.00
Equip. Location
(if different from above)
County
Equipment Description
(mfr./make/model)

Trade Reference

Company
Contact
Phone

Bank Reference

Bank
Acct#
Contact
Phone

(if account less than 2 years please provide previous bank information)


Loan Reference

 
Creditor
Acct #
Contact
Phone


Owner/Stockholder Information

Name
Percent of Ownership %
Home Addess
City
State
Zip
Title
SS#

Name
Percent of Ownership %
Home Address
City
State
Zip
Title
SS#

AEL Finance Representative:

Comments:



Authorization to Release Information
Each individual certifies that the provided information in this credit application is accurate and complete. Each individual applying authorizes you and your designees to obtain information from the references listed above and obtain a consumer credit report that will be ongoing and relate not only to the evaluation and/or extension of the business credit requested, but also for the purposes of reviewing the account, increasing the credit line on the account (if applicable), taking collection action on the account, and any other legitimate purpose associated with the account as may be needed from time to time. Each individual applying further waives any right or claim that such individual would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent.



19616 Club House Road, Gaithersburg, MD 20886
Phone: (877)632-1733 • Fax: (240)632-9315