* indicates required field

Dealer/Vendor Information









000-000-0000











Borrower Information









000-000-0000

mm/dd/yyyy








Information on Principals


Principal 1










Principal 2










Principal 3










Bank References

*(Need previous bank if less than 3 years)





Major Trade References

Reference 1





Reference 2





I/we hereby authorize BB&T Commercial Equipment Capital, to investigate my/our credit worthiness and financial responsibility from the information provided above and from any other available sources. Please provide them with the information on the accounts listed above. You will be serving my/our best interests by responding promptly.

If you are entering into a lease transaction and the leased equipment is located in one or more of the states listed below, the leased equipment will be assessed and taxed for Personal Property Tax (PPT) by the appropriate taxing jurisdiction(s) of the location of the leased equipment.

AK - Alaska
AL - Alabama
AR - Arkansas
AZ - Arizona
CA - California
CO - Colorado
CT - Connecticut
DC - District of Columbia
FL - Florida
GA - Georgia
ID - Idaho
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MI - Michigan
MO - Missouri
MS - Mississippi
MT - Montana
NC - North Carolina
NE - Nebraska
NM - New Mexico
NV - Nevada
OH - Ohio
OK - Oklahoma
OR - Oregon
RI - Rhode Island
SC - South Carolina
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VT - Vermont
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming