LW Submit App

Note:All shaded fields are required.

Business

Name:
Sole proprietors - please enter your full name as you sign it on legal documents in the Name field and your business name in the Doing Business As field. All other company types should enter the full legal name of the business as registered with the state.
Doing Business As:
Business Structure:
Federal Tax ID: (NNNNNNNNN)
Years in Business:
Street 1:
Street 2:
City:
State: Zip:
Phone: (NNNNNNNNNN)
Fax: (NNNNNNNNNN)
Email:
Contact Name:
Contact Phone: (NNNNNNNNNN)
Contact Cell: Fax:
Contact Email:
Note: Enter equipment address only if it is different than the business address shown above.
Equipment Street 1:
Equipment Street 2:
Equipment City:
Equipment State: Zip:

Terms and Conditions

Term: Cost:
Contract Type: Residual Amt:

Equipment

Equipment #1:
New/Used: Cost:
Description:

Equipment #2:
New/Used: Cost:
Description:

Equipment #3:
New/Used: Cost:
Description:

Equipment #4:
New/Used: Cost:
Description:

Equipment #5:
New/Used: Cost:
Description:

Guarantors

Guarantor #1:
SSN: (NNNNNNNNN) Date of Birth: (MM/DD/YYYY)
First Name: Last Name:
Street Number:
Street Name: Street Type:
City:
State: Zip:

Guarantor #2:
SSN: (NNNNNNNNN) Date of Birth: (MM/DD/YYYY)
First Name: Last Name:
Street Number:
Street Name: Street Type:
City:
State: Zip:

Guarantor #3:
SSN: (NNNNNNNNN) Date of Birth: (MM/DD/YYYY)
First Name: Last Name:
Street Number:
Street Name: Street Type:
City:
State: Zip:

Vendor

Vendor Name:
Phone: Fax:
Email:
Contact Name:
Additional Notes:

Retype the characters from the picture:

This application submitted electronically shall have the same force and effect as if the application bore an inked original signature(s). The above information, together with any accompanying financial statements, schedules, or other materials, is submitted for the purpose of obtaining credit and is warranted to be true, correct and complete. You authorize Western Equipment Finance, Inc. and/or its designees to confirm and verify all information entered above, which may include obtaining credit reports either in connection with this application or at any time during the term of the lease / finance agreement. You agree to release and waive all claims against Western for all acts or omissions that occur in verifying the information. Customer Identification Program: To help the government fight the funding of terrorism and money laundering activities, Federal Law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. What this means to you: when you open an account, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver's license and other identifying documents.

I accept the above terms and conditions.