Liquidation or Selling Equipment Application


How did you hear of triconleasing.com?

Business Information
Name of Company:
Address:
City:
State:
Zip:
Phone:
Fax:


Equipment Information
Full Description of Equipment:
Original Cost:
Date Purchased:
Current Value:
Is Equipment Owned:
If Not Owned, Answer All Questions Below.
Amount Owed:
Monthly Payment:
Name of Financial Company or Bank:
Account #:
Phone:
Financial Contact Name:

Contact Information
Name:
Phone:
Cell:


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:

  Accepted As Digital Signature