TCGI Capital - Leasing Application

BUSINESS INFORMATION                                  
Business Legal Name Time In Business Under Current Ownership Federal ID #
Business Address City State
Zip Business Phone Number Business Fax Number
Email Address Type Of Ownership State of Incorporation
Type Of Business    
   
     
PRINCIPAL INFORMATION (100% Ownership disclosure required.  Principals listed  will be required to guaranty lease.)
First Name Middle Initial Last Name
Date of Birth Title % Ownership
Social Security Number Present Address City
Sate Zip Home Phone Number
     
First Name Middle Initial Last Name
Date of Birth Title % Ownership
Social Security Number Present Address City
Sate Zip Home Phone Number
     
BANK/CHECKING & SAVINGS (If check acct. less than 2 years; provide  previous acct. number/bank)
Bank Bank Phone Bank Fax
Officer Account # How Long
CK SV CD
     
Bank Bank Phone Bank Fax
Officer Account # How Long
CK SV CD
     
EQUIPMENT LOANS/LEASES (Open or Paid)
Firm Name Phone Fax
Account # High Credit How Long
     
TRADE REFERENCES
Firm Name Phone Fax
Account # High Credit How Long
     
Firm Name Phone Fax
Account # High Credit How Long
     
EQUIPMENT INFORMATION
Vendor Name Vendor Phone Number  
 
Equipment Description    
Equipment Cost Equipment Condition  
 

I/We hereby authorize you or your agents and assigns to whom application is made to investigate my/our financial responsibility and creditworthiness and will provide financial statements, tax returns, etc. as you deem necessary.  I/We hereby represent that all of the information contained in the credit application is true, correct and complete and hereby authorize references contained herein to release and necessary information both personal and company/business. 

Notice: if your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial.  To obtain the statement, please contact TCGi Capital, LLC in writing within 60 days from the date that you are notified of our decision and we will respond within 30 days.  The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract), because all or part of the applicants income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act.  The federal agency that administers compliance with the law concerning the creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington, D.C. 20580
Signed By Signed By  
 
Title Title