Equipment to be Purchased Information

Bank Statements

Personal Information

This application submitted electronically shall have the same force and effect as if the application bore an inked original signature(s). 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. You authorize Alpine Equipment Funding, Inc. and/or its designees to confirm and verify all information entered above, which may include obtaining credit reports either in connection with this application or at any time during the term of the lease / finance agreement. You agree to release and waive all claims against Alpine Equipment Funding for all acts or omissions that occur in verifying the information. Customer Identification Program: To help the government fight the funding of terrorism and money laundering activities, Federal Law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. What this means to you: when you open an account, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver's license and other identifying documents. *
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