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CALL TODAY | 866.888.1099
Home
Products & Services
Standard Defense Package
Mobile Full Enterprise Field System
Thermal Screening
Daycare/Sr. Care, Extended Care
Film and TV Production Support Services
Restaurant an Food Service Industry COVID-19 Support Services
Agents
Pricing
Estimate Calculator
LNSGroup Credit Application
BHC Credit Application
Contact
Page
1
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Company Information
Business Name
Business Address
Tax-ID
*
City
State
Website
Signor
*
Line of Business
Years in Business
Annual Sales
Type of Business
Partnership
Proprietorship
Corporation
Non-Profit
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Personal Information of Officers, Partners or Guarantors
Owner 1
Percentage of Ownership
Owners Name
First
Last
SSN
Full Address
Home Number
Mobile Number
Owner 2 (If Applicable)
Percentage of Ownership
Owners Name
First
Last
SSN
Full Address
Home Number
Mobile Number
Company Bank Reference
Name of Bank
Average Balance
Phone Number
Dealer and Equipment Information
Dealer Name:
Contact:
Phone Number
Equipment Description:
Cost:
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Finalize
Lessee represents and warrants that (i) the above information, together with any financial statements, schedules, or other materials provided by Lessee to Brickhouse Capital LLC (“BHC”) is submitted for the purpose of obtaining credit (“Information”) and is true and accurate as of Lessee’s execution of this Lease Application, (ii) Lessee has no direct or contingent liabilities except those disclosed by Lessee to BHC in writing,, (iii) Lessee holds title to all property disclosed to BHC as assets, (iv) Lessee will immediately notify BHC in writing of any material change in the Information, and (v) any individual identified above who is either a principal, a personal guarantor or a sole proprietor of Lessee, recognizing that his or her individual credit history may be a factor in the evaluation of the credit worthiness of the applicant, has provided written authorization for inquiry into his or her credit history, which may include but is not limited to BHC obtaining a consumer credit report, and he or she holds BHC and its assignees, agents or nominees harmless for conducting credit inquiries. Lessee authorizes BHC to disclose all Information to BHC’s assigns, affiliates and other third parties. 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 or age (provided the applicant has the capacity to enter into the 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. If for any reason your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. This Lease Application is an application for a finance lease, as that term is defined in the Uniform Commercial Code as adopted by Arizona.
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