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APPLICATION ONLY EQUIPMENT FINANCING 
SIGNOR
NUMBER OF EMPLOYEES
ANNUAL SALES
PERSONAL INFORMATION OF OFFICERS,PARTNERS O GUARANTORS 
TYPE OF BUSINESS
 Option #1PARTNERSHIP 
 PROPRIETORSHIP 
 CORPORATION 
 NON PROFIT 
NAME
TITLE
% OWNERSHIP
SSN
HOME ADDRESS
CITY /STATE/ ZIP
NAME 
TITLE
% OWNERSHIP
SSN
HOME ADDRESS
CITY /STATE/ ZIP
HOME PHONE
NAME OF BUSINESS
EIN#
EMAIL ADDRESS
COMPANY BANK REFERENCE 
NAME OF BANK/BRANCH
AVERAG BALANCE CHECKING ACCT#
PHONE
BANK OFFICER NAME
LOAN OR LEASE REFERENCE 
NAME 
ORIGINAL LOAN AMOUNT
LOAN ACCT#
CONTACT NAME 
PHONE NUMBER
 

DECLARATION : LESSEE represents and warrants that(i)the above information together with any financial statements,schedules,or other materials provided by Lessee to (RHJ) is submitted for the purpose of obtaining  credit(Information and is true and accurate as of Lessee's execution of the Lease Application (ii)Lessee has no direct contingent liabilities except those disclose by Lessee to RHJ in  writing(ii)i Lessee holds title to all property disclosed to RHJ as assets(iv) Lessee will immediately notify RHJ in writing of any material change in the information and (v)any individuals identified above who is either a principal,a personal guarantor or a sole proprietor of Lessee,recognizing that his or her individual credit history may be a factor in the evaluation of the credit worthiness of the applicant,applicant has provided written authorization for inquiry into his or her credit history,which may include but is not limited to RHJ obtaining a consumer credit report,and he or she holds RHJ and its assignee's,agents or nominees harmless for conducting credit inquiries. lessee authorizes RHJ to disclose all information to RHJ's assigns ,affiliates and other third parties. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the base of race,color,religion,sex,martial status or age(provided the applicant has the capacity to enter into a binding contract) because all or part of the applicants income derives from any public assistance program:or because the applicant has in good faith exercise any right under the Consumer Credit Protection Act ,If for any reason your application for business credit is denied,you have the right to a written statement of te specific reasons for the denial . The Lease Application is an application for a finance lease ,as that term is defined in the Uniform Commercial Code as adopted by Arizona.