Granite Leasing Co.

P.O. Box 644 - - Columbia Falls, MT

Phone: 800-246-7997  Fax: 406-892-5072

LEASE APPLICATION

Zacklift Model ___________________  Dollar Amount Requested __________________

Exact Legal

Company Name __________________________________________________________

Address ________________________________________________________________

City _________________________________________ St. _____________________________Zip ___________

County _____________________________________________ Phone (   ) ______________________________

Fax (   )_________________________________

Time in Business _______________________ Type of Business ______________ Corporate

Fed. ID# ______________________________  Partnership

Owner /President Proprietorship

Name/Title ____________________________________________ Social Security ________________

Address _________________________________________________

Name/Title ____________________________________________ Social Security ________________

Address _________________________________________________

Credit References

Primary Business Bank ___________________________________________________ Officer ______________

Account #: Checking _____________________ Savings _________________________ Phone # ____________

Secondary Business Bank _________________________________________________ Officer ______________

Account #: Checking _____________________ Savings _________________________ Phone # _____________

Trade References

Firm Name _____________________________ Acct # __________________________ Phone # _____________

Firm Name _____________________________ Acct # __________________________ Phone # _____________

Firm Name _____________________________ Acct # __________________________ Phone # _____________

Firm Name _____________________________ Acct # __________________________ Phone # _____________

PLEASE READ AND SIGN  _________________________________  Date Signed _______________________

I (we) affirm that the foregoing information is true and correct and given for the purpose of obtaining credit and

understand that if credit is extended, Granite Leasing Co. and/or its assigners will rely on such information

to secure the indebtedness. References are authorized to provide all relevant credit information to you.

You are authorized to investigate my credit history with any of the banks or references listed above.