lease application

Lease Application

Use this simple form to get a fast, accurate quote and approval for your system lease.

Step 1 - What system do you want to lease?

Step 2 - Can you give us some brief information about your company?

Step 3 - Fast Response & Approval - You should be able to get a specific lease quote and documentation within 24 to 48 hours.

Tell us about your company and your system . . . * denotes a required field.
Contact Person's Name:*
Job Title:
Company:
Use of Product:
Address1:
Address2:
City:
State/Province:
Country:
Zip/Postal code:
Email:*
Phone:*
Fax:
Best way to contact you:
Business Structure:
Type of Business:

System Cost Estimate:
System Description:*
Lease Term required:
Date Required:
Delivery City:
State/Province:
Delivery Service:
How did you find us?

Other Requirements:
The DUNS Number for your business:	(see www.dnb.com for info)

References:
Present Bank, Branch, Account Number, Branch, Phone. List previous bank if applicant has been at present bank less that 2 years.
Three Loan/Lease/Trade References: Name, address, phone, contact person.
	A personal guarantee is required for all corporations in business for less that two years, and for all partnerships, proprietorships, professionals and service related businesses.
Personal Guarantor Name:
Personal Guarantor SSN:
	I authorize the release of any credit or financial information to our lessors.

We lease video conferencing and audio conferencing products, PC desktops, notebooks, servers, projection devices, PC displays, printers, networking devices, workstations, upgrade peripherals, communications equipment, software, systems, associated services, installation, extended warranties, Gold Seal, etc.

Please provide as much information as appropriate so that we can evaluate your request.
Your browser security settings must be set to Medium in Internet Explorer for this form to work correctly.

Notice: If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact the lessor named herein within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement. The Federal equal Credit Opportunity Act prohibits creditors from discriminating against applicants on the basis of race, color, religion, national origin, sex, marital status. age (provided the applicant has the capacity to enter into a binding contract); because all of part of the applicants' income derives from any public assistance; or because the applicant has in good faith exercised any right under the consumer protection act. The federal agency that administers compliance with this law is the Federal Trade Commission, ECOA Compliance, Washington, DC20581.

12/30/08