EQUILEASE CONSUMER CREDIT APPLICATION All fields with a * are mandatory All applications are subject to credit approval. *Have you any prior leases with Equilease?   Yes         No If so, under what name were the leases completed?
Part 1: EQUIPMENT TO BE LEASED
*General Category of Equipment: ie.Electronics, Furniture, etc.	New         Used
*Pre-Tax Cost: $
*Equipment Vendor:
Part 2: CONSUMER INFORMATION
*Full Legal Name:
* Phone Number:
*Date of Birth:
Email:
*Address:
*City:
*Province:	Select One BC AB SK MB ON QC NB NS PE NF YT NWT Nunavut *Postal Code:
* Type of Business/Employment:	*How Long?
Part 3: BANKING INFORMATION
Bank   Branch