Thank you for allowing Citi Capital Group to provide your company with lease financing for your business equipment needs. Please fill out the information requested below. You will be contacted by Citi Capital Group as soon as a credit decision has been made.

Friday
11/15/2019
06:55 AM

Credit Application

Email Notification
E-Mail Address*

Enter your e-mail address to receive a confirmation notice.
LESSEE INFORMATION
Full Legal Company Name*
Doing Business As (DBA) *
Address*
City*
State*
Zip*
Company Phone*
Company Web Address*
Business Structure*
Federal Tax ID *
Name & Title of Officer Signing Documents *
Description of Business *
Years in Business Under Current Ownership *
OFFICERS, PARTNERS or SHAREHOLDERS
OFFICERS, PARTNERS or SHAREHOLDERS 1 - required
Title *
First Name *
Middle *
Last Name *
Ownership Percentage *
Do not use a percentage sign
SSN *
Birthdate *
mm/dd/yyyy
House Number (home) *
Street Name (home) *
City (home) *
State *
Zip *
VENDOR / EQUIPMENT INFORMATION
Amount*
###.##
Term Length
Equipment Description *
Is Equipment New or Used?
Vendor Name
Sales Rep
Phone
Attach Documents
Attach Document (.doc, .docx, .xls, .xlsx, .ppt, .pptx, .pdf)
Authorization

By checking this box, 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 Citi Capital Group 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 purpose of update, renewal or extension of such credit and for reviewing or collecting the resulting account. A photostatic or facsimile copy of this authorization shall be as valid as the original.

Validation

In order to submit this application, please key in the validation code you see displayed to the left. To cut down on spam and protect the privacy of our customers, we have implemented this process. The access code you see is provided in graphic format and cannot be read by a malicious script. By taking a moment to key in the access code you are doing your part to eliminate SPAM, and helping decode books, too.

Terms
Financing is for equipment that is to be used for business purposes, and is calculated using a two (2) payment advance: 1st and Last Payment, which is held as a Security Deposit. Quoted payments do not include Taxes, Maintenance, or Insurance. Quotes are subject to credit approval and may change without notice. Quotes are for good credit. Rates and structure may change by weaker credit. Terms for startup companies may structure differently depending on industry and strength of Lessee.