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Business Information

Company Name *
Address *
City *
State *

Zip *
Phone *
Email Address *

Personal Information

First Name *
Last Name *
Social Security *	(format: xxx-xx-xxxx)
Ownership % *

Home Address *
City *
State *
Zip *

Equipment Information

Description * (Maximum 255 characters)

Equipment Cost *	$
Estimate Date of Purchase (MM/DD/YYYY)*
ACG Account Manager

Consent and Authorization

Consent, Business Review and Authorization:

The undersigned Lessee (hereinafter "Lessee") expressly authorizes American Capital Group (hereinafter "ACG") to obtain, directly or through an agent or its assignees, the Lessee's credit, background, and financial responsibility reports ("Reports") from any appropriate Reporting Agency and understand that such Reports may be used by ACG in the determination of whether or not to enter into a lease with Lessee.  Lessee understands that such investigations may include seeking information as to the background, credit and financial responsibility of Lessee's officers and principals, or any of them.  Lessee understands and consents that its credit information may be transmitted via the Internet, that such information may be accessible by unintended 3rd parties, that it is being submitted at our own risk, and that Lessee waives any right to any punitive damages arising out of or associated with the transmission, interception, use or misuse of the application. Lessee may request the status of this application to be transmitted by electronic mail and Lessee expressly authorizes ACG or its nominee(s) to transmit such message to the electronic mail address, which Lessee may provide.   Lessee hereby consents to allowing ACG to obtain any and all Reports from any and all appropriate Reporting Agencies and agrees that such information maintained by such Reporting Agencies will be supplied to ACG and/or any other companies which subscribe to said services.  Lessee therefore authorizes the procurement of said Reports by ACG and, if Lessee enters into a lease agreement with ACG, Lessee understands that this authorization shall remain on file and shall serve as on-going authorization for ACG to procure additional Reports at any other time during the lease agreement.

I hereby AGREE to the Consent and Credit Authorization describe above. *

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FAST AND EASY

"They were fast and efficient, very professional and friendly. I'm very pleased."

Gregory V - Arborite Tree & Landscape, Inc.

"Very easy and people are nice to work with. "

Jamie D - Subsurface Imaging, Inc.

DIRECT LENDER

"(ACG) was very helpful from the first phone call to the final paperwork.

Dorris P - The Print Factory, P.L.L.

"It was great everything went as (ACG) had explained it....No SURPRISES!!!"

Richard M - Will Duett

PERSONALIZED SERVICE

"A very professional operation that insures customer satisfaction through excellent communication and problem solving abilities."

Clifford B - Brown's Eye Care

"Customer for life"

Justin C - CF Cutting LLC

See Additional Testimonials


First Name:
Last Name:
Company Name:
Phone Number:
Email Address:
Equipment:
Equipment Cost:
TIB Years:
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Get Started Today

Thank you for the opportunityto serve You

Thank you, we will get back to you soon!!

Thank you for the opportunity
to serve You