Starter Application

Get the process started with our STARTER APP!

Please complete the short application below to get the process started.

IMPORTANT NOTE REGARDING CREDIT...

PLEASE NOTE ** that unless strong guarantors are available, Park Western will typically not consider deals which involve past bankruptices, repossessions, open tax liens, significant judgments and/or foreclosures. Also, please note that we do not serve the immediate El Paso, TX area.

* First Name

* Last Name

* Business Name

* Type of Business?

Proprietorship

Partnership

Corporation

LLC

* Address

* City

* State

* Postal Code

* Phone

* Email Address

* How long have you been in business?

Park Western will consider start-up businesses, so long as the owner of the company is a current homeowner.

* Please answer the following questions.

	Yes	No
Have you ever had a repossession?
Have you ever filed bankruptcy?
Have you ever had any judgments against you?
Are there any suits or legal actions pending against you?
ARE YOUR TAXES PAID CURRENT?

* Please describe the equipment that you are interested in financing/leasing?

Who are you getting the equipment from? (if known)

What is their phone #?

* Cost of equipment?

Are you currently working with someone from our office? If so, who?

Comments...

* FOR YOUR PROTECTION AND SAFETY, WE WILL CONTACT YOU BY PHONE TO GET SOCIAL SECURITY NUMBERS IF NECESSARY. By marking YES below, you declare that the information provided on this application is true, complete and correct. Furthermore, by marking YES below, you hereby authorize banks, trade references and creditors to release credit information to Park Western Leasing, Inc. (PWLI) and/or it’s assigns. You further authorize PWLI and/or it’s assigns to obtain credit information including D&B reports and credit bureau reports. You understand that PWLI relies on information provided herein in advancing credit to me and/or the company I represent. You also understand that PWLI may search public records to aid in its consideration of my application, or as verification of information provided on the application.

Yes

* First and Last name of person completing this form:

* Indicates Response Required