1st Equipment Leasing Company

Contact Name:
Company Name:
Street Address:
City, State, Zip:
E-mail:
Business Phone:
Business Fax:
Type of Equipment:
Vendor/Supplier Name:
Vendor/Supplier Phone:

Briefly describe type of business:

Number of years in business: (under present ownership)
Business Status:
Equipment Cost:
New or Used:	New Used
Officer Name:
Officer Address:
Officer City, State, & Zip:
Social Security #:

Bank Name:
Bank Phone #:
Account #:
Contact:

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:

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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 - info@acceleratedleasing.com