Fax Application

5800 Jameson Ct. #7
Carmichael, CA 95608
T. 866-408-7090
F. 916.481.0397

To begin the process, please print and complete this application. You may either fax or mail the application to Affiliated Lease Funding.

Once the application is received, one of our account representatives will contact you to confirm receipt and discuss the process involved.

If you prefer, you may complete our on-line application by clicking here.

Lessee Full Company Name _____________________________________________________	Date Established _______________________________
Lessee Full Company Address _____________________________________________________	Telephone _______________________________
Federal Tax ID ________________________________	Type Of Company __Proprietorship __Partnership __Corporation __LLC Business Description _____________________________________________________
OWNERSHIP
1. Principals Name _____________________________________________________	2. Principals Name _______________________________________________
1. Home Address/City/State/Zip _____________________________________________________ _____________________________________________________	2.Home Address/City/State/Zip _____________________________________________________ _____________________________________________________
1. Home Phone _____________________________________________________	2. Home Phone _____________________________________________________
1.Social Security# _____________________________________________________	2.Social Security# _____________________________________________________
1.Title _____________________________________________________	2.Title _____________________________________________________
1.% of Ownership ___________________	2.% of Ownership _____________________
BANKS AND LENDERS
1. BANK/LENDER ___________________________________________________	Officer _____________________________________________________
Name On Account ___________________________________________________	Account# _____________________________________________________
Date Opened ___________________________	Bank/Lender Telephone Number ________________________________
TRADES
1.Company Name ___________________________________________________	2.Company Name ___________________________________________________
Phone _____________________________________________________	Phone _____________________________________________________
Location ___________________________________	Location _______________________________
Account # or Contact ___________________________________	Account # or Contact _______________________________
INSURANCE
Company Name _____________________________________________________	Phone _____________________________________________________
EQUIPMENT
Vendor _____________________________________________________	Contact Name _____________________________________________________
Phone _____________________________________________________	Type of Equipment ___New ___Used
Equipment Description _____________________________________________________	Cost _____________________________________________________
AUTHORIZATION Please read carefully. By signing below, each undersigned individual(s), who is either a principal of the credit application listed or a personal guarantor of its obligations, provides written instruction to Broker or its designee (and any assignee or potential assignee thereof) authorizing review of his or her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the application or the credit applicant and subsequently for the purposes of update, renewal or extension of such credit and for reviewing or collecting the resulting account. A photostatic, internet on-line or facsimile copy of the authorization shall be valid as the original.

Signature _____________________________________________________ Print Name _____________________________________________________	Date _____________________________________________________
Signature _____________________________________________________ Print Name _____________________________________________________	Date _____________________________________________________

Affiliated Lease Funding, Inc. email.lease@affiliatedlease.com
Northern California T. 866-408-7090 F. 916.481.0397	Southern California T. 866-408-7090 F. 310-305-4099