Credit Application

Vendor Information
Distributor Name: ICS AUTO Inc.		Contact:			Phone: (718) 951-0800
Distributor Address: 1216 McDonald Ave. Brooklyn NY 11230					Fax: (718) 677-0349
Equipment INFORMATION
Equipment Description (attach sheet if not enough room) VeDiS Scan Tool				Supplier Auto Land Scientech		Model Complete Unit		New Used
lEASE Terms
*Lease Amount (before tax)*	Factor		Term in Months				Amount Collected In Advance $
Program Conventional Stretch	Lease Program Type $ 1.00 Residual 10% Residual At Term Other

Applicant Information

Full Legal Name of Business			DBA, if any
Business Street Address		City, State, Zip Code				Phone No. ( )
Nature of Business	Federal I.D. #	Years This Ownership		Proprietorship Partnership Corporation LLC		Fax No. ( )
Principal No. 1 Full Name (Last Name, First, MI)			Title / % Ownership _________ %			Social Security No. – –
Principal No. 1 Street Address City, State					Zip Code	Home Phone ( )
Principal No. 2 Full Name If Applicable (Last Name, First, MI)			Title / % Ownership ________ %			Social Security No. – –
Principal No. 2 Street Address City, State					Zip Code	Home Phone ( )

Applicant References

Bank #1 City, State, Zip Code

Business Checking Account No.

How Long?

Bank Officer

Phone No.

( )

Bank #2, If Applicable City, State, Zip Code

Business Checking Account No.

How Long?

Bank Officer

Phone No.

( )

Authorization To Release Information

This is not a purchase agreement. Your signature only authorizes Arrow Capital and/or it’s assigns to make a complete credit check on your company and the principals listed above; to contact the references listed above; and, authorizes these references to release information, by phone or fax, deemed necessary for establishing credit with Arrow Capital and/or it’s assigns. *For transactions above $75,000 please provide audited or reviewed financial statements for the last two fiscal years and current interim financials. If audited or reviewed financials are not available, the previous two years' business tax returns will suffice. At lease one trade reference should include credit comparable to the amount being applied for.

Authorized Signature:______________________________________________________________________ Date:___________