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for a printable PDF application
"
*
" indicates required fields
Company Information
*
Company Name
*
Company Address
*
City
*
State
*
Zip
*
Business Phone
Business Fax
*
e-Mail Address
*
Years in Business
Website Address
Contact Information
*
Name
*
Title
*
Phone #
*
e-Mail Address
Name
Title
Phone #
e-Mail Address
Name
Title
Phone #
e-Mail Address
Equipment Information
*
Type of Equipment
New
Used
New and Used
*
Describe your products
*
Range of Equipment Costs sold by your company
$1,000-$10,000
$10,000-$50,000
$50,000-$100,000
$100,000+
Sales Information
*
How many sales executives sell your product from your location?
*
Other Locations?
*
What is your estimated annual leasing volume?
$1,000-$10,000
$10,000-$50,000
$50,000-$100,000
$100,000-$500,000
$500,000-$1,000,000
$1,000,000+
List any other direct lenders/leasing companies that you currently work with
By clicking send the undersign agrees that the information provided to Paramount Financial Services, LLC, "PFS" is true, correct, and complete. The undersign authorizes PFS to obtain the credit history of the company and the officers and principals of the company and to investigate (directly or indirectly) such credit history from any source.
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