Applying For
Lease/Finance
Working Capital
Both
Step 1: Company Information
Step 2: Customer Information
Step 3: Equipment Information
Step 1: Company Information
New Company
Existing Company
Legal Company Name
Operating Name (DBA)
Business Type
---
Limited Liability Partnership
Partnership
Sole Trader
Limited Company
Community Interest Company
PLC
Charity
Unknown
In Business Since
Physical Address
City
Postcode
Business Phone
Ext.
Business Fax
Email Address
Website
Average Annual Revenue
Average Bank Balance
VAT Reg. Number
Company Registration
Step 2: Customer Information
Principal 1
Remove Principal
Add Principal
New Contact
Existing Contact
First Name
Last Name
Job Title
Percent of Ownership
Home Address
City
Postcode
Home Phone
Mobile Phone
Email Address
National Insurance No.
Date of Birth
Marital Status
---
Single
Married
Divorced
Widowed
Home Ownership
Own
Rent
Value of Home
Mortgage Balance
Outstanding Judgements or Legal Proceedings?
No
Yes
Principal 2
Remove Principal
Add Principal
New Contact
Existing Contact
First Name
Last Name
Job Title
Percent of Ownership
Home Address
City
Postcode
Home Phone
Mobile Phone
Email Address
National Insurance No.
Date of Birth
Marital Status
---
Single
Married
Divorced
Widowed
Home Ownership
Own
Rent
Value of Home
Mortgage Balance
Outstanding Judgements or Legal Proceedings?
No
Yes
Principal 3
Remove Principal
Add Principal
New Contact
Existing Contact
First Name
Last Name
Job Title
Percent of Ownership
Home Address
City
Postcode
Home Phone
Mobile Phone
Email Address
National Insurance No.
Date of Birth
Marital Status
---
Single
Married
Divorced
Widowed
Home Ownership
Own
Rent
Value of Home
Mortgage Balance
Outstanding Judgements or Legal Proceedings?
No
Yes
Principal 4
Remove Principal
Add Principal
New Contact
Existing Contact
First Name
Last Name
Job Title
Percent of Ownership
Home Address
City
Postcode
Home Phone
Mobile Phone
Email Address
National Insurance No.
Date of Birth
Marital Status
---
Single
Married
Divorced
Widowed
Home Ownership
Own
Rent
Value of Home
Mortgage Balance
Outstanding Judgements or Legal Proceedings?
No
Yes
Principal 5
Remove Principal
Add Principal
New Contact
Existing Contact
First Name
Last Name
Job Title
Percent of Ownership
Home Address
City
Postcode
Home Phone
Mobile Phone
Email Address
National Insurance No.
Date of Birth
Marital Status
---
Single
Married
Divorced
Widowed
Home Ownership
Own
Rent
Value of Home
Mortgage Balance
Outstanding Judgements or Legal Proceedings?
No
Yes
Principal 6
Remove Principal
Add Principal
New Contact
Existing Contact
First Name
Last Name
Job Title
Percent of Ownership
Home Address
City
Postcode
Home Phone
Mobile Phone
Email Address
National Insurance No.
Date of Birth
Marital Status
---
Single
Married
Divorced
Widowed
Home Ownership
Own
Rent
Value of Home
Mortgage Balance
Outstanding Judgements or Legal Proceedings?
No
Yes
Step 3: Equipment Information
Equipment Description
Vendor Company Name
Vendor Contact Name
Vendor Contact Number
Estimated Equipment Cost
Equipment Status
New
Used
Working Capital Amount
Budgeted Monthly Payment
Time Frame
---
Immediate
Within 30 Days
30 - 90 Days
Not Sure
Comments
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Thank you for submitting your application. We look forward to working with you. Please expect a sales executive to contact you shortly.
Lease Reference Number:
Working Capital Reference Number:
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For questions about financing, contact Adamantean Phone: +44 20 3858 0161 Email: contact@adamantean.net
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