Mobilexhibit: ON-LINE LEASE APPLICATION

MOBILEXHIBIT Communications Task Trailers

lease now!

Find out how fast and easy it is to lease a Mobilexhibit MX2000! Complete this easy, on-line Lease Application now. No tax returns or Financial Statements required.

application

Please complete the form below as thoroughly as possible.
Insufficient information may delay the processing of your application.

Required fields are denoted with a *

Lessee (Complete Legal Name of Entity)

Company Name *
DBA
Address *
City *	State *	Zip *
Phone *	Fax
Contact Person	Title
Type of Business: Proprietorship Partnership Corporation Non-Profit
Nature of Business
Years in Business

Personal Information

Name	Title
Address	City, St., Zip
Social Security No.	% of Ownership

Name	Title
Address	City, St., Zip
Social Security No.	% of Ownership

Company Bank References

Bank Name	City/State
Phone	Account #

Bank Name	City/State
Phone	Account #

Trade References

Supplier Name	City/State
Phone	Contact

Supplier Name	City/State
Phone	Contact

Supplier Name	City/State
Phone	Contact

Equipment Supplier Information

Supplier Name
Address
City	State	Zip
Phone	Fax
Contact Person	E-mail Address

Equipment to be Leased

Description: New Used	Equipment Cost:
1.	$
2.	$
3.	$

Payment Plan

Term Requested:
24 Months 36 Months 48 Months 60 Months

By submitting this form electronically, I hereby authorize our banks, trades and personal credit bureaus to release credit information to Mobilexhibit Corporation and/or its assignees.