Vendor Information
Name:
Address:
City:
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Zip:
Phone:
Fax:

How did you hear of triconleasing.com?
Other:

Lessee Information
Name:
Address:
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State:
Zip:
Phone:
Fax:
Years in Business:

Officers/Owners (if corporation, list president)
Name:
Title:
Social Security #:
Address:
City:
State:
Zip:
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Name:
Title:
Social Security #:
Address:
City:
State:
Zip:
Phone:

Bank Account Information (Provide 2 year history)
Bank Name:
Contact Officer:
Account Number:
Phone:

Bank Name:
Contact Officer:
Account Number:
Phone:

Trade References

Trade #1
Name:
Contact :
Phone:

Trade #2
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Contact :
Phone:

Trade #3
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Contact :
Phone:

Loan/Leasing Reference
Name:
Contact:
Account Number:
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Contact Fax:

Equipment Description
List Description:
Months Desired:
Equipment Cost:

Bank Disclosure Statement
 
The undersigned authorizes full disclosure of information pertaining to his/her business account(s) with your institution. Please communicate such information to TRICON LEASING GROUP, LTD., and or its assigns. We, the company, will hold the bank harmless in releasing such information whether by fax, or by other common means as the bank may dictate.
Type your Full Name
for use as a signature:

Startup's, Working Capital Leaseback & Transportation Equipment
 
These deals require a submission fee of $795 due to it's industry, type of loan, and or time in business. This assures our underwriters and staff that upon approving a transaction, you as the lessee would be in a position to move forward. This fee is fully credited back at time of approval. Should transaction be declined, Tricon will remit your payment minus a processing charge not to exceed $425.00. Please complete the secure order form below.



Name:
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Method of Payment:  

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Money Order