Gage's Granite Financing Application

To apply, simply fill out the form below and click submit or click on the button below to download the credit application. Once complete, fax your application to: 1-800-579-0293

Lessee
*All fields required
Company Name
DBA:
Fed Tax ID:
Address:
City, State & Zip
Business Phone #:
Fax#:
Contact Name:
Email:
URL: http://www.
Business Description:
Time In Business Under Current Ownership:	Years: Months:
Type of Business:

Vendor
*All fields required
Company Name:
Address:
City, State & Zip:
Telephone:
Contact:

Bank References
*All fields required
Principal Bank:
Account Numbers:
Telephone:
Contact:

Personal Information on Officers, Partners or Owners
*All fields required
Name:
Home Address:
City, State & Zip:
Telephone:
Social Security #:
% Ownership:

Trade References (3 Business Credit References)
*All fields required
Company:
Contact Name and/or Account#:
Telephone:
Fax:

Company:
Contact Name and/or Account#:
Telephone:
Fax:

Company:
Contact Name and/or Account#:
Telephone:
Fax:

Equipment to be Leased
*All fields required
Description:
Cost:
Condition:
Number of Months:
Monthly Payment (does not include sales tax):
Purchase Option: