Equipment Lease Application

Business Ownership

Principal 1

Principal 2

Principal 3

Principal 4

Bank References & Insurance Information

Vendor/Supplier & Equipment

Financing Options

Credit Application Disclosures and Authorizations

Acknowledgement & Authorizations By signing the below, the credit applicant(s), certify that the information given for credit purposes is true and correct. You authorize Sertant Capital, LLC, its representatives, agents, and assigns, and any credit bureau or other investigative agency to investigate the references, statements and other information accompanying this application and make any other consumer or commercial inquiries deemed necessary by Sertant Capital, LLC; and you expressly authorize bank and trade references listed herein to release credit and information requested as part of said investigation. Sertant Capital, LLC is not a manufacturer, seller or distributor of any equipment and makes no representation or warranty whatsoever with respect to the condition, specifications, operation, performance, value, design, durability, suitability and/or fitness for a particular purpose, of any such equipment. You authorize us to obtain and review these individuals' credit information for purposes of determining whether to extend credit. We reserve the right to request additional information from you regarding these individuals and any other disclosures made by you in this application.

Important Information About Opening An Account: Sertant Capital, LLC complies with Section 326 of the USA PATRIOT Act. 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 for 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 or other identifying documents. You hereby certify that any individual listed in this Credit Application is a citizen or lawful permanent resident of the United States.

Equal Credit Opportunity Act Notice: If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain this statement, send a request to Sertant Capital, LLC, 620 Newport Center Drive, Suite 1450, Newport Beach, CA 92660, 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 Credit 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. For assistance from the federal agency that administers compliance with the law concerning this credit, contact the Federal Reserve Consumer Help Center, PO Box 1200, Minneapolis, MN 55480. Sertant Capital, LLC All rights reserved. © 2017