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Venture Capital Study
What is Venture capital?
Debt or Equity?
20 Questions

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Online Equipment Leasing Application

Venture Capital/Asset Based Financing or Commercial Mortgage Financing Available:

Equipment Lease Application:
Firm Name:
Equipment Address:
City:
State:
Zip:
Email Address:
Business Telephone:
Business Fax:
Type of Business:
Date Established or Inc:
Federal Tax I D Number:
Company Ownership:	Sole Partnership Corporation Other
Major Stockholder Owner:
Stockholder Title:
Stockholder Credit Rating:	A+ A B C
Percent of Ownership:
Home Address:	City State Zip Phone
Second Stockholder Owner:
Stockholder Title:
Percent of Ownership:
Stockholder Credit Rating:	A+ A B C
Home Address:	City State Zip Phone
Home Owner:
Renter:
Landlord Name:
Landlord Phone Number:
Business Bank or Branch:	City State Zip Phone
Officer PhoneBank:
Account Number:
Type of Accounts:	Checking Savings Money Market
Loans at this Bank:	Yes No
Major Supplier:	Contact Name City State Zip Phone
Major Supplier:	Contact Name City State Zip Phone
Major Supplier:	Contact Name City State Zip Phone
EQUIPMENT To Be Acquired:
Vendor Name:	Contact Name City State Zip Phone
Equipment Description:
Terms Requested:	Two Years Three Years Four Years Five Years Special
Cost of Equipment:
I Authorize Credit Check:	I Agree I do not Agree

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