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Complete an application in one of these convenient ways:
  • Complete the on-line express application below
  • Download a form to complete and fax back to (303) 731-4009
  • Call Tod Siegel today at 1-866-612-9293, Ext. 245
  • Email your information to
Phoenix Sun Tanning Beds
PO Box 86
Boring, MD 21020
Ph: 866-373-5700
Fx: 		LEASE APPLICATION
Tod Siegel, Ext. 245
Ph: (866) 612-9293
Fx: (303) 731-4009
Company Information
Full Legal Company Name
Address
City
County
State
Zip
Contact Person
Telephone
Fax
Nature of Business
Fed. Tax ID #
Time in Business

Vendor Information
Amount
New or Used
Equipment Description
Corporation  Proprietorship  Non-Profit  Partnership  LLC 
Location of Equipment (if different than above)
Years at this Location 
Email Address    
Personal Information for all Owners, Officers and Guarantors
Name
Title
SSN
%Ownership
Home Address / City / State / Zip
Home Phone Number
Name
Title
SSN
%Ownership
Home Address / City / State / Zip
Home Phone Number
  Credit Authorization:
Credit Authorization: I/We hereby authorize Pinnacle Leasing, its designee, assigns or potential assigns to review his/her personal credit profile provided by national credit bureaus in considering this application and for the purpose of updating, renewing, extending additional credit or the collection of any late account. I/We hereby authorize our references to release all credit information and I/We represent and warrent that the information submitted herein is true, complete and accurate. A facsimile, electronic or other copy of this authorization shall be as valid as the original

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