Online Credit Application

Preferred Language is:
Who is your assigned First Capital Leasing Account Manager? select NONE for none
Contact Information
Legal Company Name:
Operating Name:
Address:
Address Line 2:
City: Prov/State:
* If your city does not appear in the menu, please select "Other City" (1st option) and enter it. We will add it to our menu. Thank you.
Country: Postal/Zip:
Phone/Ext: /Fax:
Cell:
Contact First Name: Last Name:
Email Address: Title:
Business Class: Years in Business:
Industry Type: # Employees:
Website: Annual Sales $: no spaces
Comments: Please use this section to provide background information that may help expedite processing of this application.
Equipment Information
Description:
Cost: (excluding taxes, no spaces):  Currency  New or Used
Will this equipment be located at the same/main address as above?
Vendor Information
Vendor Name:
Contact:
Phone:
Email Address:
Lease/Loan Information
Term: End of Lease Option: Monthly Payment: