PC Server & Parts Financing Ltd
2950 W Square Lake Rd Ste 211
Troy MI 48098-5725
Business Lease Application
Fax To: 877-824-2640
Tel: 866-393-4848
Lessee information
Full Legal Name of Business
Date
-
Month
-
Day
Year
Date
Trade Name or DBA (If any)
Telephone
-
Area Code
Phone Number
Fax
Email Address
example@example.com
Lessee's Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Equipment Location (If different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years in Business
Years Under Present Control
Nature of Operations
Sole Proprietor
Corporation
LLC
Partnership
Non-Profit
Federal Tax ID#
Principals
Principal's Full Name
Title
Social Security #
Complete Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Telephone
-
Area Code
Phone Number
Principal's Full Name
Title
Social Security #
Complete Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Telephone
-
Area Code
Phone Number
Banks
Bank Name
Account Number
Telephone Number
-
Area Code
Phone Number
Bank Name
Account Number
Telephone Number
-
Area Code
Phone Number
Equipment
Brief Equipment Description (A detailed equipment proposal or invoice is required prior to preparation of the Lease Contract.)
Equipment Cost Without Tax
Lease Term - 36 Months
Special Instructions
Supplier
Supplier Address
PC SERVER AND PARTS
55960 GRAND RIVER AVE, NEW HUDSON
MI 48165-9396
Phone: 248-305-7900
Supplier Contact
Email
example@example.com
Signature
Authorized Signature
Title
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: