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BUSINESS INFORMATION
Corporation
Partnership
Sole Proprietor
Non-Profit
FULL LEGAL BUSINESS NAME YEARS IN BUSINESS?
ADDRESS – Street, City, County, State & Zip Code HOW LONG AT ADDRESS?
BUSINESS PHONE NUMBER FAX NUMBER CELLULAR PHONE NUMBER
FEDERAL TAX ID NUMBER TYPE OF BUSINESS

BUSINESS FINANCIAL INFORMATION:
BANK NAME / BRANCH PHONE NUMBER CONTACT
TYPE OF ACCOUNT ACCOUNT NUMBER DATE OPENED
NAME & ADDRESS OF WHO FINANCED PREVIOUS TRUCK OR AUTO PURCHASE? CURRENT BALANCE?

PRINCIPAL / GUARANTOR INFORMATION:

NAME – Last, First, Middle

POSITION IN COMPANY?

PERCENT OF OWNERSHIP?

ADDRESS – Street, City, County, State & Zip Code

YRS/MOS. AT ADDRESS?

/ /

DATE OF BIRTH

SOCIAL SECURITY NUMBER

$

Present Landlord, Rental Agent or Mortgage Co.

Monthly Rent/Mortgage Payment (include Taxes & Insurance)

Have you ever been bankrupt?

Ever had a Repossession?

Any Taxes Past Due?

NAME & ADDRESS OF LAST EMPLOYER (if less than 3 yrs at present employer)

LENGTH OF EMPLOYMENT?

Do you:

OWN

RENT

CONTACT

PHONE NUMBER

NEAREST RELATIVE NOT IN HOUSEHOLD? - Name & Address

PHONE NUMBER

RELATIONSHIP?

CREDIT RELEASE AUTHORIZATION:

The information given above is true and complete. Astralease Associates, Inc. may receive from and disclose to other persons, including credit agencies, information about Applicant’s accounts and credit experience. Applicant authorizes any person to release to Astralease Associates, Inc. credit experience and account information on Applicant. This shall be continuing authorization for all present and future disclosures of account information and credit experience on Applicant made by Astralease Associates, Inc, or any person requested to release such information to Astralease Associates, Inc.

Electronic Signature Date Email Address

Contact us.

Email Address:
sales@astralease.com
Address:
200 Motor Parkway, Suite D-21
Hauppauge, NY 11788
Phone:
toll free (800) 390-5251
local or in NY (631) 265-8933
Fax: 631-265-8994