HTML Lease Application
Form
Click here for Word 97 Application
Form
Print this form, fill in the information, and fax to
Sunbelt Lessors, Inc.@ (972)644-6370
LESSEE INFORMATION:
Legal Name:___________________________________________________________________________
Contact:____________________________________________ Title:______________________________
Address:______________________________________________________________________________
City:__________________________________County:__________ State:____ Zip code:_______
Type of Business:___________________________________ Years in Bus:______
Bus. Phone:_______________ Fax:_________________ Fed Tax ID or Soc Sec :__________________
[ ]Corp. (Date of Incorporation):__________ [ ] Partnership [ ] Proprietorship
Location of equipment if different from above:________________________________________________
VENDOR AND EQUIPMENT INFORMATION:
Vendor's Name:_________________________________ Ph:____________ Contact:________________
Address:___________________________________ City:__________________ State:___ Zip:________
Manufacturer:___________________________Model:______________[ ] New[ ] Used
Description:_________________________________________________No. of Units:_____
Cost of Equipment:_____________Lease Term: 24 mos.__ 36 mos.__ 48 mos.__ 60 Mos.__
PERSONAL INFORMATION:
Name:_______________________________ Home Ph:__________ SS#:__________ % Ownership:___
Address:____________________________________ City, State, & Zip___________________________
Name:_______________________________ Home Ph:__________ SS#:__________ % Ownership:___
Address:____________________________________ City, State, & Zip___________________________
BANK REFERENCES:
Name:___________________________________ Account #:____________ Contact:________________
City:___________________________________________ State:__________ Phone: ________________
TRADE REFERENCES:
Name:___________________________________ Account #:____________ Contact:________________
City:___________________________________________ State:__________ Phone: ________________
Name:______________________________________ Account #:___________ Contact:______________
City:___________________________________________ State:_______ Phone: ___________________
Name:______________________________________ Account #:___________ Contact:______________
City:___________________________________________ State:__________ Phone: ________________
AUTHORIZATION:
Signature:______________________________________________________________