Vendor Name:

Address:

Telephone:

Sales Person:

Mail: PO Box 25130 Fresno CA 93729

Street: 231 E Denise Fresno CA 93720

Telephone: 559-434-7138 Fax: 559-434-4122

Lease application (business)

Name of Company

Contact

¨ Corporation ¨ Partnership ¨ Proprietorship

Time in Business Yrs:       Mos:

Phone Number (       )

Address          (Street)                          (City)           (County)

(State)         (Zip)

Description of Equipment

COE

Term

Tax

Payment

Shipping

Advance Rentals

Total Cost

¨ New ¨ Used

Address Where Equipment Will be Located

Home Phone Number

Owners – officers – guarantors

Name

Title

Home Address                              Zip

Social Security No.

bank – finance – leasing references

Name

Branch

Officer/Contact

Telephone

Account No.

trade references

Name

Contact

Telephone

Account No.

Additional information

Insurance Agent                                   Telephone

Landlord                                   Telephone

PLEASE READ BEFORE SIGNING By signing below, the undersigned individual as principal of and/or guarantor for the applicant authorized Hyatt Leasing Company, its designee, assigns or potentially assigns, to review his/her personal credit profile provided by national credit bureaus in considering this application and for the purpose of the update, renewal, or extension of credit to the Applicant or the collection of any resultant accounts. A fax or photocopy of this authorization shall be valid as the original.

Person Authorized to Sign Lease Documents (Please Print)

Lessee:

By:

Title:

Date: