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Vendor Information

Business Legal Name*

D/ B/ A Name (if any)

Entity Type*

Sole Proprietorship
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Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Federal Tax ID*

Annual Sales Volume*

Monthly Lease Volume*

Primary Contact Name*

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Title*

Phone*

Email*

Consent & Authorization

CREDIT INFORMATION RELEASE The undersigned authorizes and instructs any person, consumer reporting agency or bank institution to compile and furnish the Lessor with any information it may have in response to any inquiry from the Lessor. I/We further certify that under penalty of law that all of the above statements are true and complete and are for the purpose of obtaining credit. I/We also authorize Summit Funding Group, its affiliates or its assigns obtain your credit release data.

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Vendor Information

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