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To Process Application- Complete Application, Print App, Sign App, Fax or Mail

Lesee's Legal Name:
Lessee's Email Address:
Street Address:
State, Zip:
Contact Name:
E-Mail Address:
Nature of Business:
Time In Bussiness:
Type of Business: Proprietorship PartnershipCorporation Sub S LLC PublicOther
Year of Incorporation:
State of Incorporation:

Bussiness Information Principal(s)

SS# --
City, State, & Zip

Lessee Bank Reference 1.

Account #
Acct. Officer: Phone #
2.Name Account#
Acct. Officer: Phone #

Trade References

1.Company Name: Phone #
2.Company Name: Phone #
3.Company Name: Phone #
4.Company Name: Phone #

Equipment Information

Type of Equipment:
Estimated Cost Range:
Desired Term:
Purchase Option:
Vendor Name:
Contact & Phone#
Release: To Whom This May Concern: This will be your authority and my request for you and/or your assigns to obtain any information requested concerning personal or company credit.

(please print or type name)
Other Information:

1. After filling out form, press Submit  to transmit Application. 
2.  Print out this form (Press Print button on your browser)
3. The printed form must be signed in order for us to process.
4. Mail or fax the signed application. 
Our 24-hour Fax Line: (630) 543-3299.
Our address is Avenue One Leasing, 191 Mitchell Ct., Addison IL 60101
Thank You.

EQUAL CREDIT OPPORTUNITY ACT NOTICE: If your application for business credit is denied, you may have the right to a written statement of the specific reasons for the denial. To obtain the statement please contact: Credit Manager, Avenue One Leasing, Inc., 191 Mitchell Court, Addison, IL 60101 within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement. The federal Equal Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington, D.C. 20580

Back to: Avenue One Leasing, Inc.