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Houston Dynamic Displays

PO Box 218142
Houston TX 77218

Phone: 713-493-2565
Fax: 303-731-4009
www.houstondd.com

Lease Application
Leanne Leman
Phone: 928-301-2761
Fax: 303-731-4009
LeanneL@pinnaclelease.com

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

Company Type

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

County

State

Zip

Home Phone Number

Name

Title

SSN

%Ownership

Home Address

City

County

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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