Equipment Funding Ltd. Equipment Financing for All Businesses and their Needs    PLEASE HORIZONTAL PRINT FORM FOR BEST RESULTS EQUIPMENT FUNDING LTD EQUIPMENT FINANCE PO BOX 985 * SCOTTSDALE, AZ 85252 APPLICATION 480 949 0710 TOLL FREE 800 445 8396 FAX 480 949 7012 __________________________________________________________ Business Name / Date Est. __________________________________________________________ Business Adress / How long __________________________________________________________ Line of Business / Phone Number __________________________________________________________ Previous Business if less than 2 years __________________________________________________________ Location of Equipment __________________________________________________________ Ownership: Proprietorship( ) Partnership( ) Corporation( ) Fed. ID.# State of Incorporation: __________________________________________________________ Name of Principals/Title SS# Home Address/Phone 1 _______________________________________________________ 2 _______________________________________________________ 3 _______________________________________________________ 4 _______________________________________________________ 5 _______________________________________________________ Bank Reference Branch Phone # Officer ACCT# 1. 2. 3. 4. Trade/Lease/Finance Phone# City/State Contact Acct# References 1. 2. 3. 4. 5. Supplier of Equipment Contact Phone Number _________________________________________________________ Address / Cost of Equipment __________________________________________________________ Description of Equipment/ Delivery Date 1. ___ 2. ___ 3. ___ 4. ___ Term Request ________ Option Requested _______ By signing below,the undersigned individual who is either a principal of the credit applicant or a personal guarantorof its obligations, provides written instructions to Equipment Funding Ltd (EFL)or its designee, assignee or potential assigneee thereof authorizing review of his/her personal credit profile from the national credit bureaus. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purpose of update renewal or extension or additional credit and for reviewing or collecting the resulting account. A photostat or facsimile copy of this authorization should be valid as the original. By signature below, I/we affirm /my/our identity as the respective individual(s) identified in the above application. In addition I/We hereby authorize the bank, trade and financial institutions to release credit information to EFL and or its assigns. The uindersigned represents that all information provided in this application is tru and correct. Date _________Signature(s)/title _________________ __________________ ________________________