Full Legal Business Name Start Date Address 1 Address 2 City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip County Phone Cell Phone Fax Business Type Corporation Partnership LLC Proprietor Other State of Organization Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Tax ID Briefly describe operations Name of 1st Owner Date of Birth SSN Title % of Ownership Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Name of 2nd Owner (If Any) Date of Birth SSN Title % of Ownership Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Equipment Description: Equpment Estimated Cost Equipment Location Lesse Sales Tax Exempt Yes No If Yes Reason Lessee Property tax exempt Yes No Attach File Insurance Company Agent Name Agent Email Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Name Contact Address Phone Email For the purpose of obtaining the credit described above, and any future credit granted to the undersigned by BB Community Leasing Services, Inc. (lessor), the undersigned, jointly and severally, (1) represent that the undersigned is authorized to sign this Application and that the above statements are true and complete, (2) authorize the lessor, or its agents, to verify them and obtain additional information concerning our credit, employment history or any other information, including credit reports (although lessor may rely on these statements without any further verification), to furnish such information and any other credit experience with me to others, to answer any questions about our credit experience and other financial relationships with the lessor, (3) represent that additional financial information (including but not limited to copies of income tax returns of corporation and/or officers, personal financial statements and corporate financial statements) requested by lessor is considered part of this credit application and are free of any material misstatement or omission, (4) agree to the provisions of any rules, regulations or agreements of the lessor governing such credit, and (5) agree that this application is lessor’s property. The lessor may share information bearing on my credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics or mode of living with its affiliates unless I direct the lessor at the address shown above that such information if unrelated to my transactions or experiences with the lessor may not be shared by the lessor with its affiliates. I authorize lessor to share any information obtained in connection with this lease transaction with any purchaser or assignee of lessor’s interest in any lease with lessee or any other party involved with the funding for this or any future lease transaction requested by lessee. Undersigned further consents to Lessor obtaining, and hereby gives consent and authorization to any bank, any credit files and internal bank write-ups, reports and related information which may be required by Lessor to perform credit underwriting elated to this application. The undersigned understand that it may be a federal crime punishable by ne or imprisonment or both to knowingly make any false statements concerning any of the above facts, under the provisions of title 18, United States code, section 1014. If I have signed this Application as a potential guarantor or a principal or I have provided my personal information above as a principal of lessee, then I hereby authorize lessor or its agents to verify the above statements and obtain additional information concerning my credit, employment history or any other information, including a credit report. I autho rize lessor to share any information obtained in connection with this lease transaction with any purchaser or assignee of lessor’s interest in any lease with lessee or any other party involved with the funding for this or any future lease transaction reque sted by lessee. Name Title Date Applicant Signature Name Title Date Applicant Signature Send