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Company Legal Name

Address

City

State/Province

Zip/Postal

Country

Contact Name

Phone

Principal Information

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City

State/Province

Zip/Postal

Country

Ownership Status

Bank References

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Bank Name

Bank Account Number

Phone

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Funding Source Reference

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Source Name

Account Number

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Additional Information

Total Volume for the last 12 Months

Average ticket size

% of volume from Direct Lessees

% from Vendors

Number of leases over $500,000

Number of employees

Number of offices

Anticipated Volume to VFI Corporate Finance for the next 6 months

Has the company or any principal filed bankruptcy?

Has the company or any principal been terminated by a funding source for fraud, misrepresentation?

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I/We certify that the above information is true and correct and I/we authorize any bank, financial institution, or trade reference to release any information as may be requested by Varilease Finance, Inc. And or its assigns. I/We also hereby authorize Varilease Finance, Inc. to obtain other background or credit information and relate this information to others as necessary.

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