APPLICATION FOR LEASE FINANCING
Legal entity
Filled in application to be delivered by fax 6 630 841 or e-mail

APPLICANT

Business name / Registry code / Address
Contact person / Phone / E-mail / Contact address
Main areas of activity
since year
since year
since year
Applicant belongs to group of companies whose
parent company is / Applicant does not belong to group of companies
Data on each natural person owning directly or indirectly (e.g. via other companies) or controlling otherwise more than 25% of shares or voting rights of the applicant
Name / Personal ID code / Citizenship / Share of ownership
%
%
%
No natural person owns directly or indirectly or controls otherwise more than 25% of shares or voting rights of the applicant
Applicant's financial obligations (loan, leasing, deferred payment, factoring, suretyship, guarantee)
Creditor / Balance / Final maturity date

SELLER AND LEASING OBJECT

Seller's name / Contact person / Phone / E-mail
Leasing object / Purchase price without VAT

TERMS APPLIED FOR

Financial leasing with VAT financing / Financial leasing without VAT financing / Operational leasing
Leasing period months / Down payment% of purchase price / Residual value % of purchase price
Monthly payment date 5th date 20th date
Leasing invoices to be sent atemail address or postal address
Other terms (e.g. subsidy by PRIA or EAS etc)

Sales offer of the leasing object and the applicant's latest financial statements (balance sheet and income statement) must be enclosed to the application.

The applicant hereby confirms that the submitted data are correct. The applicant is aware that Pohjola Finance Estonia AS may ask from the applicant additional data to decide on matters related to the financing. The applicant hereby agrees that Pohjola Finance Estonia AS may ask information from third parties in order to verify correctness of the submitted data and to obtain additional data about the applicant.

The applicant hereby consents to exchange of information with Pohjola Finance Estonia AS, incl. sending of contracts and related documents, via e-mail. The applicant is aware that e-mail cannot be guaranteed to be secure or error-free channel as the information sent could become public, be altered by third person or due to computer viruses or other technical reasons. The applicant acknowledges that sender of the email shall not be liable for its content becoming public or for any errors or omissions therein which may arise as a result of the e-mail transmission.

SIGNATURE OF THE APPLICANT'S REPRESENTATIVE

Representative's name / Basis for representation
Signing date
Signature