LEASE APPLICATION

Granite Leasing logo

PO Box 644 * Columbia Falls, MT 59912
(406) 892-5068 * (406) 892-5072 * (800) 246-7997

Company:

Exact Legal Name:
Mailing Address:
City:
  State:     Zip:  
Phone:
  Fax:  
Email:
Physical Location:
City:
  State:     Zip:  
Fed ID #:
Type of Business:
Business Structure:

Ownership:

Legal Name:
Social Security #:
Home Address:
City:
  State:     Zip:  
Home Phone:
  Cell Phone:  
Title:
  % of Ownership:  

Legal Name:
Social Security #:
Home Address:
City:
  State:     Zip:  
Home Phone:
  Cell Phone:  
Title:
  % of Ownership:  

Bank References:

Primary Business Bank:
Checking Account #:
Officer/Contact:
Phone:
  Time at Bank:  

Trade References

Firm Name: Contact: Phone:

Firm Name: Contact: Phone:

Firm Name: Contact: Phone:

Equipment

Vendor: Contact: Phone:

Equipment: Total Price:

By signing below, each undersigned individual(s), who is either a principal of the credit applicant listed below or a personal guarantor of its obligations, provides written instruction to Granite Leasing Company or its designee (and any assignee or potential assignee thereof) authorizing review of his or her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the application of the credit application and subsequently for the purposes of update, renewal or extension of such credit and for reviewing or collecting the resulting account. TYPING YOUR NAME IS LEGALLY THE SAME AS YOUR SIGNATURE.

Signature                                            Date         

Signature                                            Date         

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. 20S80.

If your application for business credit is denied, you have the right to a written statement of the specific reasons for denial. To obtain the statement, please contact lesscr set forth above within 60 days (ram the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement.

Additional Comments