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Type of Business (or applying as:) An Individual Corporation Limited Partnership General Partnership Municipality

Have you ever filed for bankruptcy? Yes No

Has a judgment ever been filed against you? Yes No

For purposes of obtaining credit, I (we) certify that all the information in this statement is true and correct and accurately describes my (our) financial condition as of the date shown, and that there has been no material change since then. I (We) grant permission to Signature Capital, LLC, dba Signature Leasing to verify all information in this statement and to provide any information requested by my (our) other creditors. I also grant SignatureLeasing permission to obtain a credit report on me for all legitimate purposes in connection with this transaction. Such purposes include assisting in making a credit decision, reviewing my account and assisting in taking collection activity. I (We) also grant permission to those creditors to provide all information requested by Signature Leasing. I (We) release all claims against Signature Leasing and my (our) other creditors for all acts or omissions which occur in verifying the above information. Ohio Applicants: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on individual upon request. The Ohio Civil Rights Commission administers compliance with this law. Maine Applicants: If this application is approved by the creditor, you will be required to obtain and maintain physical damage insurance on the collateral securing the debt. You have a right of free choice in the selection of the agent and insurer through or by which insurance is placed.

I have read and accepted agreement above