{\rtf1\ansi\deff0\deftab720{\fonttbl{\f0\fnil MS Sans Serif;}{\f1\fnil\fcharset2 Symbol;}{\f2\fswiss\fprq2 System;}{\f3\fnil Times New Roman;}{\f4\fnil Courier New;}} {\colortbl\red0\green0\blue0;} \deflang1033\pard\plain\f4\fs20 \par \par \par \par \par \par Live Bait Vendor Lease Application \par \par \pard\plain\f4\fs20 \par
\par \par
\par
 One Stop Bait Shop TM \par Live Bait Vendor
\par \par
Steve's Bait 129 South St. Galion Ohio 44833
\par \par
PH. (419) 468-3478   Fax. (419) 462-7594   \par E-mail: baitman@usa.com
\par \par

\par \par
Lease Application
\par \par

\par Legal Business Name:  \par
Address:  \par
City:    \par State:    Zip Code:  \par
Phone #:    \par Extension:  \par
Fax #:  \par
Contact Person:  \par

\par
Item Description: Live \par Bait Vending Machine        Price: $ \par 3395.00 \par
Quantity Desired:  \par

\par
Years in Business:    \par Type of Business:  \par
Federal Tax ID Number:  \par

\par
Circle one:          \par Corporation         Partnership           \par Proprietorship
\par  
\par
Personal Information of Officers Partners or Grantors \par
Name:  Title:  \par
Home Address:  \par
City:    \par State:    Zip Code:  \par
Home Phone #:  \par
Social Security Number:  \par

\par
Name:  Title:  \par
Home Address:  \par
City:    \par State:    Zip Code:  \par
Home Phone #:  \par
Social Security Number:  \par

\par
Company Bank References - Two Year History  \par
(please provide prior bank reference if current bank relationship is \par less than 2 years) \par
Name of Bank Branch:  \par
City:    \par State:    Zip Code:  \par
Phone #:    \par Fax #:  \par
Checking Account #:  \par
Loan Account #:  \par

\par
Name of Bank Branch:  \par
City:     \par State:     \par Zip Code:  \par
Phone #:    \par Fax #:  \par
Checking Account #:  \par
Loan Account #:  \par

\par
Trade References - Two Year History \par
Name of  Supplier:  \par
Account #:     \par Contact Person:  \par
Phone #:    \par Fax #:  \par

\par
Name of  Supplier:  \par
Account #:     \par Contact Person:  \par
Phone #:    \par Fax #:  \par
 
\par
Name of  Supplier:  \par
Account #:     \par Contact Person:  \par
Phone #:    \par Fax #:  \par

  \par
Bank and Trade Release
\par \par
I hereby authorize our bank and trade references \par to release the information requested by Center Financial Leasing Inc. regarding \par our company's accounts with your firm.  Please respond to their telephone \par request or by fax,  if you need written proof of the request and our \par release.
\par \par
This is Your Written Authorization to Release \par the Information Requested.
\par \par

\par Authorized By:  \par
Title:   \par Date:  (MM/DD/YYYY) \par \par \par



\par

\par
\par
 This \par site designed by Barbara Gottfried
\par \par \par \par \par }