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Equipment Leasing Application

Contact Name:
Company Name:
Street Address:
City, State, Zip:      
Business Phone:
Business Fax:
Type of Equipment:
Briefly describe type of business:
Number of years in business: (under present ownership)
Business Status:
Equipment Cost:
New or Used: New
Officer Name:
Officer Address:
Officer City, State, & Zip:    
Social Security #:
Bank Name:
Bank Phone #:
Account #:
Trade Reference Name 1:
Trade Reference 1 Phone #:
Trade Reference Name 2:
Trade Reference 2 Phone #:

Please comment on any pertinent
information that we may find useful:

Once you have completed the above form, please press the "Submit Application" button below.  Please press the button only once and wait for an acknowledgement page to load.


1st Equipment Leasing Company
A division of BAJ Financial Solutions

710 Southwest 174th Terrace
Pembroke Pines, Florida 33029

Toll Free: 1 (800) 603-1644
Local: (954) 450-4343
Fax: (954) 450-4352
E-mail -

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