HalcyonFinance Company Online Finance and Lease Application

Call 1-408-779-0050 or 1-408-529-3311 For Customer Service. Please fill out the complete application.
Company Information

Company Name:

Mail Address:

City:

State:

ZIP Code:

Contact:

Phone:

Fax Number:

E-mail Address:

Years in Business:

Federal Tax ID#:

DUNS#

 Sole Proprietorship   Corporation LLC Limited Partnership General Partnership  
Trust   

Equipment

Description of Equipment:

Equipment Location:

Address:

City:

State:

Zip Code:

Equipment Cost:

Requested Terms:

Vendor

Name:

Contact:

Mail Address:

City:

State:

Zip:

Phone:

Fax Number:

Bank Information

1. Bank Name:

Phone Number:

Fax Number:

Account Number:

Contact:

 

 

2. Bank Name:

Phone Number:

Fax Number:

Account Number:

Contact:

Trade References - Please include at least one bank loan and/or lease if available.

1. Name of Business:

Phone Number:

Fax Number:

Account Number:

Contact:

 

 

2. Name of Business:

Phone Number:

Fax Number:

Account Number:

Contact:

 

 

3. Name of Business:

Phone Number:

Fax Number:

Account Number:

Contact:

 

 

4. Name of Business:

Phone Number:

Fax Number:

Account Number:

Contact:

Officers

Owner/President:

Percent of Ownership:

Social Security Number:

Date of Birth:

Home Address:

City:

State:

ZIP Code:

Phone Number:

Fax Number:

 

 

Additional Officer:

Percent of Ownership:

Social Security Number:

Date of Birth:

Home Address:

City:

State:

ZIP Code:

Phone Number:

Fax Number:

Additional Comments:

  By clicking here I authorize and request for you to release any and all information concerning personal or company credit information/ratings by phone or fax to lease financing institutions in an expeditious manner. I hereby consent to receiving faxes and emails wherein the Lessor/Broker will advertise certain products and services and also consent to the photocopying of my drivers license for verification purposes in connection with a commercial equipment finance transaction.To the best of my knowledge, all of the information contained herein is accurate and true.