Phone 949-999-3306 Email phillip@unitedleasingdist.com United Hospitality Equipment Division of United Capital Home About Us Equipment & Hospitality Services Application Contact Us Application Secure Business Application ATax I.D number Company Address* City State* Zip Phone* Fax Email Nature of Bussiness Type Of Business (Check One) CorporationPartnershipSole Proprietor Tax Exempts YesNo Years in Bussiness Principal 1 Title % Ownership Home Address Social Security Number City State Zip Principal 2 Title % Ownership Home Address Social Security Number City State Zip Bank Information & Trade References Name of Bank Contact Phone Check Account Number Trade Reference 1 Contact Phone Trade Reference 2 Contact Phone Vendor/Supplier of Equipment Vendor Contact Phone Equipment Description Price Total Build Out Cost* Is the Equipment* NewUsed Estimated Delivery Date (Check One)* 30 Days60 Days90 DaysOver 90 Days Structure Requested Term (Check One)* 36 Months48 Months60 Montths Buy Out (Check One)** $1 Buy Out10% Buy OutTrue Lease Information Release By clicking the submit button, I hereby authorize United Capital Funding Services, its designees or assigns to make business and or personal credit inquiries as necessary throughout the lease. I understand that this may include a personal credit bureau which will be used in the credit evaluation process. I also authorize United Capital Funding Services, its designees or assigns to contact me via any means or media deemed necessary.
