Leasing Application

PACWESTMANAGEMENT, INC.

*Please fill in all sections of this form or your application will not be processed*

Date

Address of Interested Property

Name and Type of Business Interested in Starting

How much do you plan on spending on this business?

Fist and Last name

Partner/Spouse Name

Social Security #

Driver License#

Date of Birth

Marital Status (Married, Divorced, Separated)

Estimated Credit Score

Home Number #

Office Number #

Cell PhoneNumber#

Fax #

Email Address

Present Home Address

# of Year

City

State

Zip Code

Do you own your home?

If yes, please state the year you purchased your home

Previous Home Address

# of Years

Please fill the first company information

1. Name of Company

Present/Previous Work Address

Date

City

State

Zip Code

Do you/ Did you own this business?

Business Phone #

# of Years Owned/Length of Employment: Beginning Date (Month/Year)

Ending Date (Month/Year)

Position held when first employed

Position held when you left

Reason for selling/leaving/closing the business

Please fill the second company information

2. Name of Company

Present/Previous Work Address

Date

City

State

Zip Code

Do you/ Did you own this business?

Business Phone #

# of Years Owned/Length of Employment: Beginning Date (Month/Year)

Ending Date (Month/Year)

Position held when first employed

Position held when you left

Reason for selling/leaving/closing the business

Please fill the third company information

3. Name of Company

Present/Previous Work Address

Date

City

State

Zip Code

Do you/ Did you own this business?

Business Phone #

# of Years Owned/Length of Employment: Beginning Date (Month/Year)

Ending Date (Month/Year)

Position held when first employed

Position held when you left

Reason for selling/leaving/closing the business

Please fill the fourth company information

4. Name of Company

Present/Previous Work Address

Date

City

State

Zip Code

Do you/ Did you own this business?

Business Phone #

# of Years Owned/Length of Employment: Beginning Date (Month/Year)

Ending Date (Month/Year)

Position held when first employed

Position held when you left

Reason for selling/leaving/closing the business

List of Personal References