Blog | Contact Us Equipment Leasing Leasing FAQ Payment Calculator HOME PRODUCTS & SERVICES CAPITAL EQUIPMENT VENDOR TESTIMONIALS ABOUT US Equipment Leasing Application Secured Connection Business Information Company Name * Address * City * State * Select AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NM NV NH NJ NY NC ND OH OK OR PA OR RI SC SD TN TX UT VT VA WA WV WI WY Zip * Phone * Email Address * Personal Information First Name * Last Name * Social Security (format: xxx-xx-xxxx) Ownership % * Home Address * City * State * Select AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NM NV NH NJ NY NC ND OH OK OR PA OR RI SC SD TN TX UT VT VA WA WV WI WY Zip * Equipment Information Description * (Maximum 255 characters) Equipment Cost * $ Estimate Date of Purchase (MM/DD/YYYY)* ACG Account Manager Consent and Authorization Consent and Authorization for Credit Report: The undersigned Lessee (hereinafter "Lessee") expressly authorizes American Capital Group (hereinafter "ACG") to obtain, directly or through an agent or its assignees, the Lessee's credit, background, and financial responsibility reports ("Reports") from any appropriate Reporting Agency and understand that such Reports may be used by ACG in the determination of whether or not to enter into a lease with Lessee. Lessee understands that such investigations may include seeking information as to the background, credit and financial responsibility of Lessee's officers and principals, or any of them. Lessee understands and consents that its credit information may be transmitted via the Internet, that such information may be accessible by unintended 3rd parties, that it is being submitted at our own risk, and that Lessee waives any right to any punitive damages arising out of or associated with the transmission, interception, use or misuse of the application. Lessee may request the status of this application to be transmitted by electronic mail and Lessee expressly authorizes ACG or its nominee(s) to transmit such message to the electronic mail address, which Lessee may provide. Lessee hereby consents to allowing ACG to obtain any and all Reports from any and all appropriate Reporting Agencies and agrees that such information maintained by such Reporting Agencies will be supplied to ACG and/or any other companies which subscribe to said services. Lessee therefore authorizes the procurement of said Reports by ACG and, if Lessee enters into a lease agreement with ACG, Lessee understands that this authorization shall remain on file and shall serve as on-going authorization for ACG to procure additional Reports at any other time during the lease agreement. I hereby AGREE to the Consent and Authorization for Credit Report above. * FAST AND EASY "They were fast and efficient, very professional and friendly. I'm very pleased." Gregory V - Arborite Tree & Landscape, Inc. "Very easy and people are nice to work with. " Jamie D - Subsurface Imaging, Inc. DIRECT LENDER "(ACG) was very helpful from the first phone call to the final paperwork. Dorris P - The Print Factory, P.L.L. "It was great everything went as (ACG) had explained it....No SURPRISES!!!" Richard M - Will Duett PERSONALIZED SERVICE "A very professional operation that insures customer satisfaction through excellent communication and problem solving abilities." Clifford B - Brown's Eye Care "Customer for life" Justin C - CF Cutting LLC See Additional Testimonials © 1995-2021 - American Capital Group Inc. All Rights Reserved. DBO license #60DBO-43815 Lease and Loan Products: * Are Not insured by the FDIC or any other federal government agency * All investments are not guaranteed by any Bank Affiliate * Lowest Payment Guaranteed subject to these terms and conditions. Nationwide Capital Holdings, Inc. makes leasing available through American Capital Group, Inc. Financing products offered by American Capital Group and affiliates. Privacy Policy Security & Legal Report email fraud