Opes Financial Lease Application
Please complete all applicable items.
If you have any questions, please contact us at 1.888.684.4355.
Customer Information for Business and Industry
Full Legal
Company Name
DBA
Company Address
City
State, ZIP
Phone
Fax
E-Mail
Years in Business
Number of Employees
Business Owner's Name
Title
Years as Owner
Legal Structure
State of Incorporation
Federal Tax ID Number
 
Principal 1 Name
Address
City
State
ZIP
E-Mail
Social Security No.
Ownership %
Principal 2 Name
Address
City
State
ZIP
E-Mail
Social Security No.
Ownership %
Bank and Trade References (for business and industry applicants only)
Bank 1 Name
Phone
Account No.
Contact
Bank 2 Name
Phone
Account No.
Contact
 
Trade Ref 1 Name
Phone
Account No.
Contact
Trade Ref 2 Name
Phone
Account No.
Contact
Equipment and Vendor Information (all applicants must complete this section)
Vendor Name
Vendor Contact
Vendor Phone
Vendor Fax
Purchase Time Frame
Estimated Equip. Cost
Annual Budget
Structure Preference
Buyout Options
Specify If Other

Additional Comments




By pressing "Submit", Business and Industry applicants, in recognizing that his or her individual credit history may be a factor in the evaluation of the credit of the applicant, hereby consents to and authorizes Opes Financial Solutions and any assignee, lender or funding service that may be utilized to obtain and use a consumer credit report on the named applicants, now and from time to time, as may be needed in the credit evaluation and review process and waives any right or claim they would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent.

I (we) certify that all of the information in this application is complete and accurate to the best of my (our) knowledge.