FINANCE APPLICATION

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City (required)

State (required)

Zip (required)

Equipment Location (if different than lease address above)

City

State

Zip

Principle or Officer

1

Home Address

Zip

2

Home Address

Zip

Bank References (Exact Branch)

List all banks used for last 5 years

Trade Reference or Term Debt

1

Account No.

Phone No.

Contact Name

2

Account No.

Phone No.

Contact Name

3

Account No.

Phone No.

Contact Name

Credit Information Release Authorization

To Whom It May Concern:

This document should serve as notice to you that I/we are considering an equipment acquisition. This document will serve as your
authorization to release any/or all credit information regarding my/our account(s) and any/or all corporate financial statements on
file to any leasing company, bank or financial institution that may be involved in providing credit accommodations for the
acquisition of this equipment.

Business Name:

Address

Print Name

Title

Name

Date

By submitting this application, you certify that all the information you have given or will give with this application is true and
complete. You authorize Novation Vendor Services, its assigns, affiliates and/or parents to make a complete credit check on the
company and principals of the same as individuals and to relate this information to others as necessary to secure a credit decision.
Your submission also authorizes any information that may be requested by Novation Vendor Services, its assigns, affiliates and/or
parents including but not limited to bank, trade references, and/or financial statements.

FAX COMPLETED APPLICATION TO: 888.408.2466