Business Information
Company Name * Phone * Fax * Date Established * Company Type * Select... LLC CORP Partnership Sole Proprietorship Tax ID *	Address * City * State * Zip * Country * Nature of Business *
PRINCIPALS / GUARANTORS INFORMATION
Principal 1 * Name * Home Address * Home Phone * Email * % Ownership * Position * City * State * Zip * Mobile Phone * Soc. Sec. Number * Date of Birth *	Principal 2 Name Home Address Home Phone Email % Ownership Position City State Zip Mobile Phone Soc. Sec. Number Date of Birth
COMPANY BANK REFERENCE
Bank Name * Bank Contact Name * Bank Contact Phone *	Account Number * Account Type * Select... Savings Checking Other Bank Contact E-Mail *

BUSINESS/TRADE REFERENCES
Reference 1 * Company Name * Contact E-Mail * Phone * Fax	Reference 2 * Company Name * Contact E-Mail * Phone * Fax	Reference 3 Company Name Contact E-Mail Phone Fax

THIS WILL BE YOUR AUTHORITY AND MY REQUEST FOR YOU TO RELEASE TO ADMIRAL LEASING AND/OR ITS ASSIGNEES, ANY INFORMATION THEY MAY REQUEST CONCERNING CREDIT STANDING WITH YOUR COMPANY AND/OR MONEY ON DEPOSIT. I HEREBY FURTHER AUTHORIZE ADMIRAL LEASING AND/OR ITS ASSIGNEES, TO OBTAIN ANY AVAILABLE PERSONAL CREDIT BUREAU REPORTS, AS WELL AS BANK AND TRADE REFERENCES, AND UTILIZE PHOTOCOPIES OF THIS RELEASE IN CONJUNCTION WITH THE CREDIT APPLICATION PROCESS
For (Company Name) *	Date 02/16/2019
Officer Signature (TYPE NAME IN CAPS) *	Title *
Please check the box below and wait for the gree check mark before submitting this form.