Company Information
Corporate Name (if applicable)* Doing Business as
Address*
City* State* Zip
Time in business under current ownership* - Months Years
Business Type - Sole Proprietorship Corporation LLC Project Type - New business Additional location Relocation Expansion/Remodel
Personal Information- This is for officers, partners, or guarantors
Name* Title* Social Security#*
Ownership % Home Phone* Cell Phone*
Home address*
City* State* Zip*
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Ownership % Home Phone* Home address*
Bank Information
Name of Bank/branch Account #
Account Type Personal Business Checking Savings Other Contact name
Contact phone Contact E-mail
Please provide a brief summary of applicable experience (IE: Number of years experience in the industry)
Authorization for Release of Financial Information
The undersigned represents that all information provided with this application is true and correct and hereby authorizes Beneficial Capital Leasing (BCL) to obtain from third parties, information it deems necessary to arrive at a decision regarding this application. To help fight terrorism and money laundering, the information you provide will be verified. By signing below, the undersigned individual(s) as principal of and/or guarantor for the applicant, authorizes BCL, its assigns or potential assigns, to review his/her personal credit profile provided b a national credit bureau in considering this application and for the purpose of updated, renewal, or extension credit to the applicant or the collection of any result accounts. The undersigned authorizes all deposits, borrowing, financial and trade information to be released to BCL by telephone or fax. A photocopy of facsimile of this authorization shall be valid as the original.
I agree with all information listed above. Please accept this as my signature
