Tell us about your business

Legal Business Name {{form.errors.company_name}}

DBA (Doing Business As) {{form.errors.dba_name}}

Business Type {{form.errors.business_type}} You must have a verifiable business.

Business Structure {{form.errors.business_structure}}

Federal Tax ID / EIN * {{form.errors.contact_person_federal_id}}

Name of the Director, Officers, or Managers: {{form.errors.officer_name}} Please list the names of the Director, Officer or managers along with their title in the space above.

Date Business Established *

How many Years has the company been in business? * {{form.errors.years_in_business}} Please enter the number of years your company has been in business. A value from 0 to 50

Who will be the Contact person at your company ? *
(This can be any person in charge of coordinating the lease and delivery or the copier.)

First name {{form.errors.contact_person_firstname}}

Last name {{form.errors.contact_person_lastname}}

contact person title {{form.errors.contact_person_title}}

Email * {{form.errors.contact_person_email}}

Phone * {{form.errors.contact_person_phone_number}}

company website {{form.errors.company_website}}

Equipment Address *

Is the equipment address same as business address?

Street Address {{form.errors.equipment_address.street}}

Address Line 2 {{form.errors.equipment_address.line2}}

City {{form.errors.equipment_address.city}}

State {{form.errors.equipment_address.state}}

ZIP Code {{form.errors.equipment_address.zip_code}}

Business Address *

Street Address {{form.errors.business_address.street}}

Address Line 2 {{form.errors.business_address.line2}}

City {{form.errors.business_address.city}}

State {{form.errors.business_address.state}}

ZIP Code {{form.errors.business_address.zip_code}}

There were incomplete/missing fields.

Guarantor's Details

NOTE: This is required for businesses established within the last 3 years or if your business is Sole Proprietorship.

guarantor firstname {{form.errors.guarantor_firstname}}

guarantor lastname {{form.errors.guarantor_lastname}}

guarantor title {{form.errors.guarantor_title}}

guarantor ownership percentage {{form.errors.guarantor_ownership}}

guarantor phone number {{form.errors.guarantor_phone_number}}

guarantor email {{form.errors.guarantor_email}}

Guarantor's Address *

Street Address {{form.errors.guarantor_address.street}}

Address Line 2 {{form.errors.guarantor_address.line2}}

City {{form.errors.guarantor_address.city}}

State {{form.errors.guarantor_address.state}}

ZIP Code {{form.errors.guarantor_address.zip_code}}

guarantor SSN * {{form.errors.guarantor_ssn}}

guarantor date of birth

You're on your way to an approval!

Please give us permission to process the information you submitted.

Please draw your signature to Acknowledge the terms of this application *

First Name

Last Name

Title

I agree to the terms and conditions

BANK & TRADE DISCLOSURE STATEMENT The undersigned authorizes full disclosure of information pertaining to the business credit of the undersigned applicant in processing a lease financing application for which same has applied. To allow for easy processing, lessee gives its consent to have any such information given by fax, email or any other common means as the institution may dictate. This request applies fully to Flat Rate Copiers LLC., its affiliates and or assigns thereto.

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