Become A Vendor

Become an LCA approved equipment supplier and begin offering your customers financing options on your equipment. Simply fill out the form below and a member of our sales team will contact you within 24 hours.

Equipment Supplier Business Information

Legal Name

DBA Name

Phone Number

Address

City

State

ZIP Code

Website

Primary Contact Information

First Name

Last Name

Title

Phone Number

Email Address

Social Security Number

Equipment Supplier Information cont.

Business Structure

Number of Employees

Years in Business

Is this a home based business?

Yes, my business is home based.
No, my business is not home based.

Average Monthly Equipment Sales

About Your Business

Estimate the average number of transaction your business completes each month

Average Number of Transactions / Month

Average Transaction Amount

Do you currently offer equipment financing?

Yes, my business does not offer financing
No, my business does not offer financing

of transactions financed

Current equipment leasing company

of equipment suppliers served regularly

ACH Information

Name on Bank Account

Name of Bank

Type of Account

Bank Account Number

ABA Routing

Address of Bank

City of Bank

State of Bank

ZIP Code of Bank

Bank Phone Number

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