LEASE APPLICATION

Please return via fax to OPC Marketing at 208-545-8846
Phone 972-267-3279, 3939 Belt Line Rd., #299, Addison TX 75001

Lessee Company Information: (please type or print all information clearly and completely)
Company Name ________________________________________________________________________
Company Address ______________________________________________________________________
City____________________________________________________ State________ Zip_______________
Phone _____________________________________ Fax _______________________________________
Website Address _____________________________________ Number of Employees_______________
Business Classification: Corporation _____ Partnership _____ Proprietorship _____ Non-Profit _____
Years In Business _________ Estimated Fiscal Year-End Revenue $_____________________________

Officer(s) / Partner(s) / Guarantor(s) Information:
Name__________________________________________________ Title___________________________
Social Security Number (required) _______________________________Ownership % _______________
Address _______________________________________________________________________________
City______________________________________________ State_________ Zip____________________
Phone ____________________________________ Number of Years in Present Position______________
Name__________________________________________________ Title___________________________
Social Security Number (required) _______________________________Ownership % _______________
Address _______________________________________________________________________________
City______________________________________________ State_________ Zip____________________
Phone ____________________________________ Number of Years in Present Position______________

Company Bank References:
Bank Name____________________________________________________________________________
Acct. #_____________________________________________ # of NSF in 12 months _______________
Contact Officer ___________________________________ Phone ________________________________
Bank Name____________________________________________________________________________
Acct. #_____________________________________________ # of NSF in 12 months _______________
Contact Officer ___________________________________ Phone ________________________________

Business Trade References:
Supplier Name ________________________________ Type of Business __________________________
City / State ____________________________________________________________________________
Contact Officer ___________________________________ Phone ________________________________
Supplier Name ________________________________ Type of Business __________________________
City / State ____________________________________________________________________________
Contact Officer ___________________________________ Phone ________________________________
Supplier Name ________________________________ Type of Business __________________________
City / State ____________________________________________________________________________
Contact Officer ___________________________________ Phone ________________________________

Commercial Lease / Loan Reference (Over 6 months pay history):
Institution Name ________________________________________________________________________
Account / Lease / Loan Number ___________________________________________________________
Contact Officer ___________________________________ Phone ________________________________

Equipment Description:
Description ________________________________________________ Projected Cost _______________
Vendor Name __________________________________________________________________________
Contact _______________________________________ Phone __________________________________

Please tell me more about: _____ 90-Day Payment Deferral _____ Working Capital Program (to $25,000)
_____ Seasonal Cash Flow Payment Structures _____ Master Lease Line

The above information, together with any accompanying financial statements, schedules, or other materials, is submitted for the purpose of
obtaining credit and is warranted to be true, correct and complete. The undersigned hereby warrants that any individual indentified above who
is either a principal, a personal guarantor or a sole proprietor of the credit applicant, recognizing that his or her individual credit history may be
a factor in the evaluation of the credit history of the applicant, has provided his/her written authorization for inquiry into their credit worthiness,
including but not limited to obtaining a consumer credit report, and shall hold OPC Marketing and its assignees harmless from same. OPC
Marketing is hereby authorized to investigate (directly or through an agent or nominee) your/their credit and financial responsibility. You
understand that such investigation may include seeking information as to the background, credit and financial responsibility of your officers
and principals (or any of them).

Applicant ______________________________________________________________________________
Signature (required) _____________________________________________ Date ___________________
Applicant ______________________________________________________________________________
Signature (required) _____________________________________________ Date ___________________