Direct Source Capital Commercial Lease Application

* Required Fields

Account Executive
*Lessee Full 
Company name
of Current Ownership
*Lessee Contact
*Lessee Billing address
Federal Tax No.
*Type of Business  If other, please indicate:  
If Corporation, indicate in which state you are incorporated:
Guarantors / Owners _1_* (2) (3)
*City, State, Zip
Home Number
Social Security Number
*% Of Ownership
Credit References
*Bank City/State *Phone Number Contact *Account Number
Please Note Additional Bank References at Bottom.
Bank Loan, Lease or Finance References: City/State Phone Number Contact Account Number
Please Note Additional Loan, Lease or Finance  References at Bottom.
Major Trade
City/State Phone Number Contact Account Number
Please note Additional Trade References at Bottom.
Seller of Equipment:
Seller's Company Name Address City State Zip
Contact Phone Number Fax Number E-mail
*Equipment Description     New Used

*Equipment Location (If Different From Address Above)
Term Requested Installation Date Lease Buyout Request (10%, FMV ...) Total Equipment Cost

If other, please specify:

Additional Bank, Lease, Loan, Finance or Trade Reference or Other Pertinent Information or Comments:

Credit Release
The undersigned indiv. (either a principal of the credit applicant or a guarantor of its obligations) provides this written instruction to Lessor or its nominee/assigns authorizing review of his/her pers. credit profile from a nat’l credit bureau. Such authorization shall extend to obtaining a credit profile in consideration of this application and subsequently for the purpose of update, renewal or the extension of such credit and for reviewing and collecting the resulting acct. A photostat or facsimile of this auth. shall be valid as the original. By signing below, I/we affirm our identity as the respective individuals identified in the related application. The undersigned states that all of the above statements are true & complete and authorizes Lessor to obtain from any source information re: the credit standing of the applicant or guarantors.
*X Title  Date
DSC may require Credit Authorization Form to be signed for credit releases to bank and trades.

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17581 Irvine Bl., Ste. 214
Tustin, CA 92780
Phone: 714-241-5900
Toll Free: 888-99-GO-DIRECT
Fax: 714-241-5910