I/We understand that I/We may submit my application to Madison Capital, LLC electronically by clicking "Submit Application" below, or I/We may submit the application by fax or mail.

I/We authorize Madison Capital LLC to make such inquiries regarding the information furnished herein as may be required in connection with the application, or in the course of review of any credit extended in reliance on the application, such as obtaining individual credit bureau reports, Dun & Bradstreet business reports, and/or other credit reports/references. I/We represent that all information set forth in this application is a truthful and accurate representation of facts for the purpose of obtaining the lease financing requested by me/us. If I/We choose to submit this application electronically, I/We acknowledge that Madison Capital LLC is unable to ensure that the data cannot be intercepted by third parties. In submitting this application electronically I/We knowingly and voluntarily agree that Madison Capital LLC will not be held liable in any manner whatsoever should such interception occur. I/we understand that other financial information may be requested in connection with this lease application, and that this application is not an offer to extend credit.

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