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LJP Leasing Business Equipment Leasing

950 ISOM ROAD, #105 SAN ANTONIO, TEXAS 78216 (210) 340-1615 FAX (210) 344-0767

LEASE APPLICATION

Lessee's Legal Name ____________________________________________________________________

Employer Identification Number or Social Security Number (if Proprietorship)_________________________

Business Street Address ______________________ City____________ State______ Zip Code _________

Business Mailing Address _____________________ City____________ State______ Zip Code _________

Business Telephone __________________________Type of Business _____________________________

Type of Organization: ______ Corporation ______ Partnership______ Proprietorship _____________ Other

Length of time in business ___________________ Length of time at above location ___________________

Applicant's Present Bank _________________________________________________________________

Bank Street Address _________________________ City____________ State______ Zip Code _________

Bank Telephone ______________________________ Name of Bank Officer ________________________

How long has applicant done business with this bank? __________________________________________

If less than two years, please give us your prior bank or financial reference.

Applicant's Prior Bank ____________________________________________________________________

Bank Street Address _________________________ City____________ State______ Zip Code _________

Bank Telephone ______________________________ Name of Bank Officer ________________________

Who is the principal or principals of this company? _____________________________________________

Who will personally guarantee and sign the lease? _____________________________________________

(AN INDIVIDUAL GUARANTOR WILL BE REQUIRED)

Guarantor's Street Address _____________________ City____________ State______ Zip Code ________

Guarantor's Telephone ________________________ Guarantor's Social Security No. _________________

Guarantor's Driver's license No. ____________________ From the State of: _________________________

Verified by Salesperson? _________________________________________________________________

Person to Contact for information (other than Principals) _________________________________________

Telephone _____________________________________________________________________________

TRADE REFERENCES

COMPANY NAME ADDRESS TELEPHONE NUMBER

______________________________________________________________________________________

Equipment to be Leased _________________________ Amount of Lease Requested _________________

Lease Term Requested: _____ 24 Months _____ 36 Months _____ 48 Months ______ 60 Months

PLEASE ATTACH:

1. SIGNED FINANCIAL STATEMENT (Both Balance Sheet and income Statement)

2. Brochure of Equipment to be leased.

VENDOR _________________________________

VENDOR'S TELEPHONE ____________________

SALESMAN _______________________________

The information provided on this application is for the purpose of obtaining credit and is warranted to be true. I hereby authorize the firm to whom this application is being made to investigate the references listed relating to this business' credit and financial responsibility. Furthermore, I authorize this firm to check my individual credit history in connection with a business transaction involving the company making this application.

______________________________________ __________________________________________

Name and Title/Position (Please Print) Signature Date

I am a (check one): _____ Principal _____ Guarantor _____ Other