Lease Credit Application

Please enter all information thoroughly as possible. All information will be kept confidential.

I. GENERAL INFORMATION

Property Applicant is applying for *

Applicant Legal Name *

Spouse Legal Name

Applicant Date of Birth

Spouse Date of Birth

Applicant SSN

Spouse SSN

Applicant CADL#

Spouse CADL#

Applicant Home Address

City and State

ZIP Code

Applicant Home Phone

Applicant Cell Phone

Applicant Email Address *

Spouse Email Address

Do You own or Rent your personal residence?

Rent
Own

If you rent your personal residence:

Personal Residence Landlord Name

Personal Residence Landlord Phone

Reason For Leaving

Has current Landlord been notified you're leaving

Name of relative not living with you

Relative Phone

Relative Address

In Case of Emergency, name, address, phone of person to contact other than spouse

Are you currently a party to any Legal or Administrative Proceedings?

If yes, please provide the following: Name being used in proceedings:

Date of Last Activity

County/State of Jurisdiction

Case number

Court or Agency Presiding

Have you or any other owner of your business ever filed or have had filed any voluntary or involuntary petition for bankruptcy? (If yes, please describe)

II. PROPOSED BUSINESS INFORMATION

How will you operate your business at the proposed location (who will manage, how many employees, etc.)

Describe the use intended for and activities to be conducted on the premises including products to be stored or manufactured (if restaurant, please provide sample menu, if retail store, please list brand names)

Reason For Move (example: Relocation, Expanding, New Business)

D. Describe your start up operating expenses and amounts

Tenant Improvement

Inventory

Equipment

Payroll

Insurance

Advertising

Other

TOTAL START UP EXPENSES

How will you pay for your start-up expenses (cash, business loan, etc.) ?

Do you have previous business operation experience? If so, please provide details

III. IF APPLICANT HAS EXISTING BUSINESS...

Business Name

Tax ID#

Type of Company:

Sole Proprietorship
Partnership
Corporation

If Corporation, State where Incorporated

Date of Incorporation

Current Business Phone

How Many Years in Business?

Agents Name and Company

Phone

Address

Current Business Address

City, State

ZIP Code

Is property Rented or Owned?

If Rented, monthly rent

If owned, name of Lender

Lender Phone

Current Business Landlord Name

Landlord Phone

How many years at this location?

Previous Business Address

City, State

ZIP Code

Is property Rented or Owned?

If Rented, monthly rent

If owned, name of Lender

Lender Phone

Current Business Landlord Name

Landlord Phone

How many years at this location?

IV. FINANCIAL INFORMATION

A. Employment and Income History

Applicant: Current Employer

Spouse: Current Employer

Applicant: Position or Title

Spouse: Position or Title

Applicant: Current Supervisor

Spouse: Current Supervisor

Applicant: Phone Number to Verify

Spouse: Phone Number to Verify

Applicant: Date of Hire

Spouse: Date of Hire

Applicant: Annual Salary

Spouse: Annual Salary

Do you plan on keeping employment while lease is in effect?

Applicant *

Spouse *

B. Personal Checking Account Information

Bank & Branch

Phone Number

Address

City/State/Zip

Account Number

Name and Title of Person to Contact

C. Business Checking Account Information

Bank & Branch

Phone

Address

City/State/Zip

Account Number

Name and Title of Person to Contact

D. Owner/Partners/Corporate Officers (other than Applicant)

Name/Title

Date of Birth

Home Address

City/State/Zip

Phone

Previous Address

Social Security Number

Drivers License #

Spouse

Employer

Name/Title

Date of Birth

Home Address

City/State/Zip

Phone

Previous Address

Social Security Number

Drivers License #

E. List Your Three Largest (by dollar volume) Suppliers

Name

Phone

Address

Contact Person

Account Number

Name

Phone

Address

Contact Person

Account Number

Name

Phone

Address

Contact Person

Account Number

F. List Your Three Largest (by dollar volume) Customers

Name

Phone

Address

Contact Person

Account Number

Name

Phone

Address

Contact Person

Account Number

Name

Phone

Address

Contact Person

Account Number

ASSETS: (Cash, Real Estate Owned, Automobiles Owned, Accounts Receivable, Notes, Collectibles, IRA's, 401/Sep., etc.)

Item/Volume

LIABILITIES: (Real Estate loans, loans that would not show on a credit report, Accounts payable, equipment/car/fixture leases, lines of credit, etc.)

Item/Volume

For Individuals, Sole Proprietor, General Partners, Limited Partner:

1. Attached are statements of Assets/Liabilities and Income/Expense which accurately reflect the businesses financial status (If more room is needed than provided above)

Assets/Liabilities and Income/Expenses File Upload