LEASE TO OWN APPLICATION

TELL US ABOUT YOURSELF

First Name *

Middle Initial *

Last Name *

Your Email Address *

Social Security Number *

Date of birth *

Telephone Number *

Have You or the Business Declared Bankruptcy? *

Yes

No

ARE YOU MARRIED OF SINGLE *

SPOUSE NAME *

Home Address *

City *

State *

Zip Code *

Do You Rent or Own Your Home? *

Rent

Own

For How Long? *

TELL US ABOUT YOUR BUSINESS IF APPLICABLE | INFORMATIONAL PURPOSES ONLY

Are you Self Employed? *

Yes

No

Business Structure

Number of employees (If none put a 0)

Gross sales last year $$

EIN (Federal Tax ID number)

Legal Business Name *

State the business is registered

Percentage of Ownership

Business Email Address

Business Start Date

Business Address

Years Under Current Ownership

Second Business Owners Full Name

Second Business Owner Date of Birth

Second Business Owner Social Security #

EQUIPMENT TO BE LEASE PURCHASED

NAME OF DEALERSHIP *

DEALERSHIP PHONE NUMBER *

LIST SPECIFIC MACHINE MAKE AND MODEL *

IS THIS MACHINE A : *

PRICE OF MACHINE *

DO YOU HAVE A DOWN PAYMENT *

DOWN PAYMENT AMOUNT AVAILABLE $ *

How many months are you looking for lease to own *

SUPPORTING DOCUMENTATION AND ANSWERS

Do you or will you have the following documents available if needed?

Last 2 years tax returns

Profit and Loss statement

Balance sheet

How did you hear about our Lease to Own Program *

Do you have owned equipment for collateral if required *

SPECIFIC COLLATERAL ITEMS AVAILABLE - LIST YEAR MAKE AND MODEL (TITLED ITEM) *

How will this purchase help your business?Is this a replacement, upgrade or additional piece of equipment? How will this purchase make your company more profitable?

CREDIT RELEASE AUTHORIZATION I hereby certify that the information contained in this lease application is true and accurate and I hereby authorize our ban ks, trade references, and financial institutions the right to release credit information. In states where permissible, I hereby authorize the filing and recording of UCC financing Statements showing the Secured Party's interest in the equipment and grant the Secured Party the right to execute Lessee's/debtors name thereto. A photostat copy of this authorization shall be as valid as the original. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract), because all or part of the applicant’s income derives from any public assistance program or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law is the Federal Trade Commission Equal Credit Opportunity, Washington, D.C. 20580. If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact Lessor set forth above within 60 days from the date you are notified or our decision. We will send you a written statement of reasons for the denial within 30 days for receiving your request for the statement.
Notice: To help the government fight the funding of terrorism and money laundering activities, U.S. Federal law requires financial institutions to obtain, verify and record information that identifies each person (individuals or businesses) who opens an account. What this means for you: When you open an account or add any additional service, we will ask you for your name, address and taxpayer identification number that will allow us to identify you. We may also ask to see other identifying documents.
By signing your name below, you hereby acknowledge that this will act as, and be enforceable as a signature, each undersigned individual(s), who is either a principal of the credit applicant listed below, or a personal guarantor of it's obligations, provides written instruction to High Flow Funding (aka High Flow Funding, LLC.) or it's designee (and any assignee or potential assignee therof) authorizing review of his or her personal credit profile in considering the application of the credit application and subsequently for the purpose of update, renewal, or extension of such credit and for reviewing or collecting the resulting account. A photocopy or facsimile print and/or signature of this authorization shall be valid as the original.
***PLEASE FORWARD ALL CREDIT APPLICATIONS TO HIGHFLOWFUNDING@GMAIL.COM***
*

I agree to the above terms and conditions.

Signature (If 2 business owners listed please have both signatures) * 🛈

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Proprietorship (Sole)	Partnership	Corporation
Non Profit	LLC