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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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