CHAPMAN / LEONARD Studio Equipment, Inc.
TIME SAVING CAMERA CRANES, ARMS, BASES, DOLLIES, PEDESTALS AND REMOTE CAMERA SYSTEMS
FOR MOTION PICTURE AND TELEVISION PRODUCTION
12950 Raymer Street
North Hollywood, CA  91605
888.883.6559   Fax: 888.502.7263

1.                   Company Information

Full Legal Name / Busniess Entity:

Phone Number With Area Code:

Fax Number With Area Code:

Doing Business As (Dba):

Billing Address:

City :                                                 State:                 Zip Code:         Country:

Company Type

□         Partnership

□         Proprietorship

□         Corporation

□         Other

2.                   Business Credit Information

Federal Id (If Incorporated): 

If Incorporated, Under Laws Of What State?:

Year Established:

Credit Line Requested:

If Partnership, Formed Under Laws Of What State?:

Purchase Order Required?:

3.                   Bank References

Bank Name:

Account #:

Contact:

Phone Number With Extension:

Address:

City:                                              State:                   Zip:                 Fax Number:

Bank Name:

Account #:

Contact:

Phone Number With Extension:

Address:

City:                                             State:                   Zip:                 Fax Number:

4.                   Credit References

Company Name:

Contact:

Phone Number With Extension:

 Address:

City:                                              State:                   Zip:                 Fax Number:

Company Name:

Contact:

Phone Number With Extension:

Address:

City:                                              State:                   Zip:                 Fax Number:

Payment Terms Are Net 30 Days. - A Charge Will Be Made Every Month At The Rate Of 1% Per Month (12% Per Year) On Unpaid Invoices Older Than 60 Days.  The Charge Will Run From The End Of The 60 Day Period, Until The Invoice Is Paid.  An Additional Late Fee Of 5% Will Be Assessed On Any Unpaid Invoice Older Than 120 Days.

1. Authorization
By Signing This Application, I Authorize Chapman / Leonard Studio Equipment, Inc. Or Its Agent To Investigate My Personal, Corporation, And / Or Partnership Financial Records Including Banking Records.  As Part Of Such Investigation, I Authorize Chapman / Leonard Studio Equipment, Inc. To Request And Obtain Credit Reports In Connection With The Opening, Monitoring, Renewal And Extension Of This And Other Accounts With Chapman / Leonard Studio Equipment, Inc.  If  I Request, You Will Tell Me Whether My Credit Report Was Requested By Chapman / Leonard Studio Equipment, Inc. And, If So, The Name And Address Of The Credit Reporting Agency That Furnished That Report.

By Signing Below, I The Corporation Or Partnership I Am Signing For, Agree To Pay The Rent And Other Charges Set Forth In The Documents Under Which The Equipment Is Leased And / Or Rented From You, Including Attorney's Fees And Collection Fees.

First Name:

Middle Initial:

Last Name:

Social Security Number:

Present Home Address:

City:                                    State :             Zip:                     Home Phone Number:

Authorized Signature:                                                        Title:                                 Date:

Multipule Owners

First Name:

Middle Initial:

Last Name:

Social Security Number:

Present Home Address:

City:                                    State :             Zip:                     Home Phone Number:

Authorized Signature:                                                        Title:                                 Date:

Multipule Owners

First Name:

Middle Initial:

Last Name:

Social Security Number:

Present Home Address:

City:                                    State :             Zip:                     Home Phone Number:

Authorized Signature:                                                        Title:                                 Date:

2.         Guaranty

By Signing This Application, I Acknowledge That I Have Personally Guaranteed The Debts And Obligations Of The Business As Referenced In This Application And Agree That I Am Personally Obligated To Perform All Of The Terms Of, And Make All Payments To Chapman / Leonard Studio Equipment, Inc. Required By The Agreement Of Which This Application Is A Part.

First Name:

Middle Initial:

Last Name:

Social Security Number:

Present Home Address:

City:                                    State :             Zip:                     Home Phone Number:

Authorized Signature:                                                        Title:                                 Date:

Multipule Owners

First Name:

Middle Initial:

Last Name:

Social Security Number:

Present Home Address:

City:                                    State :             Zip:                     Home Phone Number:

Authorized Signature:                                                        Title:                                 Date:

Please Fax Back Completed Form To: 818.764.9391