Lease Application
877-249-5974 toll free - 828-696-4373 local - 828-696-9772 fax

* Required fields in red.

Lessee Information
1.
Legal Business Name:

DBA:
2. Company Mailing Address:
Street:
City:
State:
Zip:
3.
Phone Number:

Fax:

Email
4.
Time in Business:
5.
Bank Name:

Phone Number:
6.
Contact:
7.
Checking Account #:
Primary Borrower Information
8.
First:

Middle:

Last:

Suffix:
9. Please enter your current mailing address:
Street:

City:
State:
Zip:
Own or Rent:
Own Rent
10.
Phone Number:

Cell Number:

Email
11. Social Security Number:
The security of your personal information is our first priority at Smokey Mountain Funding, Inc.:
12. Driver's License Number:
Co-Borrower Information
13.
First:

Middle:

Last:

Suffix:
14. Please enter your current mailing address:
Street:

City:
State:
Zip:
Own or Rent:
Own Rent
15.
Phone Number:

Cell Number:

Email
16. Social Security Number:
The security of your personal information is our first priority at Smokey Mountain Funding, Inc.:
17. Driver's License Number:
Vendor Information
18.
Vendor Name:
19. Vendor Mailing Address:
Street:
City:
State:
Zip:
20.
Phone Number:

Fax:

Email
21.
Contact:

Salesperson:
22.
Describe the equipment to be financed/Structure request:
23.
Total Amount to be Financed:
Confirmation & Authorization
You understand that by clicking on the I AGREE button immediately following this notice each undersigned individual(s), who is either a principal of the credit applicant listed below or a personal guarantor of its obligations, provides written instruction to Smokey Mountain Funding, Inc. or its designee (and any assignee or potential assignee thereof) authorizing review of his or her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the application of the credit applicant and subsequently for the purposed of update, renewal or extension of such credit and for reviewing or collecting the resulting account.
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