Financing

Please complete the following leasing form:

Vendor Name
4 WHEELS ENTERPRISES
Vendor NO.
Contact Name & Title
Tel Number
Fax Number
INFORMATION
Customer's Full Legal Name - Include Trade Name
Email Address
Contact Name & Title
Customer's Address(Head Office)
City
Province
Postal Code
Phone Number
Cell Number
Fax Number
Type of Business / SIC
Years in Business
PROPOSED TRANSACTION DETAILS
General Equipment Description:
For Office Use Only:
Equipment Description
Invoice Cost:
Less Trade-In:
Plus B/O OR T/U:
Equipment
NEW
Equipment Cost
Term to
P/O-EOL
Regular
Rental
Down
Payment
Residual
Trade-up or
buyout#
For Office Use Only:
Invoice Cost:
Less Trade-In:
Plus B/O OR T/U:
PRINCIPAL SHAREHOLDERS INFORMAITION
(1)Last Name
(1)First Name
(1)Initial
(1)S.I.N.(oPTIONAL)
Date of Birth
(mm/dd/yyy)
Home Address
City
Province
Postal Code
Own
Rent
Other
Other-Please Specify
Monthly Income
Telephone Number
Mobile Number
(2)Last Name
(2)First Name
(2)Initial
(2)S.I.N.(oPTIONAL)
Date of Birth
(mm/dd/yyy)
Home Address
City
Province
Postal Code
Own
Rent
Other
Other-Please Specify
Monthly Income
Telephone Number
Mobile Number

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