Business Info
	Type of Business
	Name
	Address
	City	State Zip
	Telephone
	Federal Tax ID
Equipment Vendor
	Name
	Contact
	Address
	City	State Zip
	Telephone
	Amount	Term
	Type of Equipment
Bank
	Name Branch Telephone Account No. Type
Trades
	Name Contact Address Telephone
Owners
	Type of Ownership
	Time in business under current ownership
	Name Title Social Security # % Ownership Home Address Home Phone
Upon submission of this form all applicants hereby provide consent to Willamette Financial Funding Services and/or assigns or potential assigns, authorizing review of his/her personal credit profile from a national credit bureau, and review of bank account and trade information now and from time to time, as may be needed in the credit evaluation and review process and waives any right or claim they would otherwise have under Fair Credit Reporting Act in the absence of this continuing consent.

Download Lease Application and fax to the Willamette Financial Funding office near you.