PLEASE PRINT, COMPLETE, SIGN AND FAX BACK TO 512-266-4986 OR 800-256-6148


Bevenco Leasing & Finance
13312 Bright Sky Overlook
Austin, TX 78732		 CREDIT APPLICATION v:(512)266-4999
(800)683-7106
f:(512)266-4986
(800)256-6148

COMPANY: (full legal name of company buying equipment)
Name
Address City State/Zip
Phone Fax County
Contact E-mail Fed ID#
Corporation

Partnership

Sole Prop

Date Business Began Type of Business

OWNERS: (individual(s) who own business)
Name Social Security #

Address

 City State/Zip
Name Social Security #
Address City State/Zip

BANKS: (company bank(s))
Name Years Account # Officer Type Phone #
1.
2.

EQUIPMENT: (the item(s) your company needs)
Quantity Description (new or used, brand, model, etc.) Price
Term of Lease (circle one): 24 Months 36 Months 48 Months 60 Months

VENDOR: (the company providing the equipment)
Name Sales Rep
Address
City State/Zip
Phone Fax


I, the undersigned hereby authorize the release of credit information, and request that all loan, credit, bank, trade or other history be given as needed to Bevenco and its assignees.
X X