Please enter contact information below. Fields with a (*) image are especially necessary because without this information we won’t be able to process your credit application. This information is for processing your credit application and contacting you, it will not be sold or redistributed.

Business Information

Company Name (*)
Contact Name (*)
Home Office Address (*)
City (*)
Zip Code (*)
Primary Phone Number (*)
E-mail Address (*)
Tax ID (*) (ex. 55-5555555)

Nature of Business
Years Established
Years Under Present Ownership
Type of Business CorporationLLCPartnershipProprietorship
Listed with Dun & Bradstreet YesNo
If yes, DUNS No.

Name of Affiliate or Subsidiary
Zip Code

Officer Title % Ownership

Majority Stockholder
(if other than Officers)
Majority Stockholder Position

Personal Guarantor

Full Name
Phone Number
E-mail Address
Street Address
Zip Code
Social Security Number
Date of Birth (ex. mm/dd/yyyy)


12-Month Delivery Forcast

Number of Forcasted Purchases
Average Vehicle Price
Vehicle Use
Vehicle Type
Total Credit Line Requested


Bank Contact Phone Account#
Vehicle Fleet Financing Contact Phone Account#

By submitting this information to us, you authorize Earth Auto Leasing to obtain your credit history from the major credit reporting agencies (Equifax, Experian, and Trans-Union).

I/We authorize Earth Auto Leasing, LLC, (the leasing/loan company and their assignees) to make any necessary credit inquiries deemed proper in connection with this lease/loan application. I/We authorize and instruct any person or consumer reporting agency to compile and furnish to the Leasing/Loan company any information that it may have or obtain in response to such credit inquiries and agree that such information, along with the application, shall remain the leasing/loan company property whether or not the lease/loan is approved. I do not authorize distribution of this information.