Taycor Financial - equipment leasing & financing

Equipment Leasing Application

1 Company Information Please complete all fields marked with an asterisk (*)

* Company Name:
* City:
* Business Phone #:
Business Description:

* Street Address:
* State: * Zip:
Business Fax #:
Type of Business: Time in Business:

2 Principal Ownership Information Please provide for all person(s) with 20% or more ownership

Officer 1

Officer Name:

Title:

Home Address:

Email Address:

Ownership %: Social Security #:
State: Zip:

3 Bank & Lease References Required for transactions over $50,000

Bank Name:

Bank Phone #:

Lease Company:

Lease Phone #:

Account #:

Account Type:

Account #:

High Credit:

4 Equipment Information Or fax the invoice/equipment description to toll-free (800) 864-0082

Seller Company Name:

Seller Phone #:

Time Frame for Purchase:

Equipment Description:

Equipment Cost:

Monthly Budget: Condition:

5 Authorization

Signature authorizes Taycor Financial or its assignees to verify credit and financial information from all appropriate sources. Such verification may include obtaining business as well as individual credit and financial background of officers and principals, as well as bank, trade, and comparable borrowing references. Submission of this form is consent that information transmitted via the Internet carries with it inherent risk when done via an unsecured network connection. Signature below must be done by only an authorized member and must be 18 years of age or older.

* Authorized Signer:

* Title:

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Equipment Leasing Application

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