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LEASE APPLICANT BUSINESS INFORMATION You may wish to print this form and fax it to 1.703.584.7106 If you need assistance completing this form call toll free 1.888.480.8532 Company Legal Name: DBA (If applicable) Company Address:   Phone Number: Fax Number: Email Address: Web: City, State, Zip:  , Date & State of Inc. Federal Tax I.D. #: Business Type: Sole Owner Partnership Corporation Other BANK REFERENCE: MAY BE REQUIRED (3 recent Summary Pages Preferred) Business Bank/Branch: Officer/Phone: Account Number: Type: Checking Savings Money Market Loans at this bank: Yes No     Date Opened: COMPARABLE LOAN & TRADE REFERENCES: May Be Required Firm Name:   City:   State: Contact:   Phone: How Long?   High Credit PERSONAL INFORMATION ON OFFICERS, PARTNERS OR GUARANTORS Owner 1 Name: Title: SSN: % Owned: Home Address: Tel: City, State, Zip: , Owner 2 Name: Title: SSN:   % Owned: Home Address: City, State, Zip: , FAX INVOICE OR QUOTE INFORMATION Sales Contact Name: Phone:  Email: Terms Requested: 2 Years 3 Years 4 Years 5 Years Special Location of Software: By submitting this application, I, authorize Blue Water Leasing, Inc. and it's agents or assigns to investigate my/our credit worthiness, as you deem necessary. I/We hereby authorize my/our references and/or any Credit Bureaus to release my/our information. I/We warrant that the information submitted herein is true and correct. Name: