Financing the equipment or software you want is easy. All it takes is a few simple steps:

1) Fill out applicable fields in our simple form below and click "Submit This Lease Application," or print and fax it toll-free to (888) 391-6728.

2) You will receive a response in about four business hours.

3) Upon approval, we will overnight the finance agreement for your signature.

4) Crest then issues a Purchase Order to the vendor(s) you have selected.
 


 

COMPANY INFORMATION

Company Name:

Street Address:

 

City:
State:
Zip +4:

 

County:
Sales Tax %:

Contact Name:

Contact Email:

Contact Phone:

Contact Fax:

 

Structure:

Subchapter 'S' Corporation

'C' Corporation

501C Corporation

Sole Proprietorship

LLC

Partnership

Years in Business:
 


OWNERSHIP/OFFICER INFORMATION

1. Officer Name:

 

Title:
% Ownership (if over 20%):

Home Address:

 

City:
State:
Zip +4:

 

SSN:
Home Phone:

 

 

 

2. Officer Name:

 

Title:
% Ownership (if over 20%):

Street Address:

 

City:
State:
Zip+4:

 

SSN:
Home Phone:


 

 


REFERENCES

(Bank Accounts should be at least two years old; if less please supply previous bank references)
 

Name of Bank:

Contact Name:

Phone Number:

Checking Account Number:

Savings Account Number:

Revolving or Installment Account Number:

 

 

TRADES

1. Name:

Account Number:

Contact:

Phone:

 

 

2. Name:

Account Number:

Contact:

Phone:

 

 

3. Name:

Account Number:

Contact:

Phone:

 


EQUIPMENT INFORMATION

New
Used     Year:

Description:

Equipment Cost Without Tax:
 

Location if Different From Billing Address:

Terms (Months) Requested:
 


VENDOR INFORMATION

Name:

Phone:

Fax:

Email:

Street Address:

 

City:
State:
Zip +4:


 

 


COMMENTS


 


The sender hereby authorizes verification of any credit information from whatever source deemed appropriate. The sender hereby authorizes banks, trade references and financial institutions the right to release by telephone or fax all credit information requested. A copy or fax of this Credit Release Authorization may be deemed to be the equivalent of the original.

Name (authorized signature):

Title:

 


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