Home
Vendors
About Us
Contact Us
Online Application
Menu
Menu
Online Application
Please confirm that all fields are complete and accurate prior to submitting. If you have any questions, please call FirstCorp Leasing at 847-324-1516.
Business Information:
Legal Business Name
(Required)
Business Phone Number
(Required)
Street Address
(Required)
Suite/Unit
City
(Required)
State
(Required)
Zip
(Required)
Contact Name
(Required)
Federal Tax ID
(Required)
Number Years in Business
(Required)
Business Type
(Required)
--None--
Sole Proprietorship
Partnership
Corporation
Limited Partnership
S Corporation
Municipal
Prof Association
Prof Corporation
Limited Liab Partnership
LLC
Prof LLC
Owner information for Partnerships, Limited Partnerships and Sole Proprietors:
First Name
(Required)
Last Name
(Required)
Title
Ownership %
(Required)
Social Security #
(Required)
Cell #
(Required)
Email Address
(Required)
First Name
Last Name
Title
Ownership %
Social Security #
Cell #
Email Address
Equipment Information:
Vendor Name
(Required)
Vendor Website Address
(Required)
Vendor Phone Number
(Required)
Estimated Equipment Cost
(Required)
Equipment Description
(Required)
Bank/Loan References:
Institution Name & Address
(Required)
Contact Person Name
(Required)
Phone #
(Required)
Institution Name & Address
Contact Person Name
Phone #
Consent
I/we hereby represent that all the information contained in this Credit Application is true, correct and complete. I/we authorize FirstCorp Leasing, LLC or its agent(s) to obtain and verify the credit information contained herein from whatever source deemed appropriate and furthermore waive any potential right or claim I/we may have under the Fair Credit Reporting Act. A copy of this Credit Application is deemed to be the equivalent of the original. This Credit Application is made under and governed by the law of the State of Illinois.
Signature
Verification, please answer 8 + 7 =
(Required)
Scroll to top
