Steve Karas and Associates

Media Capital
Media Capital Associates LLC
6991 E Camelback
Scottsdale, AZ  85251

Equipment Leasing & Financing

 Complete, Sign &
Fax Back To:

Andrea Hollins

Tel   (800) 836-7753

Fax  (480) 941-4588

  
Company Name
Address
City St Zip
Phone
[FrontPage Save Results Component]






 Vendor Steve Karas and Associates
3341 E Turquoise
Phoenix, AZ  85028
(602) 494-9090
Fax (602) 494-9134
Email skaras@cox.net

TYPE OF COMPANY

CORPORATION, State    PARTNERSHIP   PROPRIETOR 
YEAR FORMED       FED TAX ID:
WHAT DOES COMPANY DO:
EQUIPMENT Cost (Excluding Tax) $ 3,995.00                NEW USED

LEASE TERMS
 

12
24 36
48 60

TERMS REQUESTED

MONTHS $
% TAX $
TOTAL $
PURCHASE OPTION
FMV
10%   
$1.00
0THER		 ADVANCE RENTALS

FIRST PMT
LAST   PMT
OTHER
FEE $ 

BANKING  INFORMATION
BANK: PH: ( ) - CONTACT :
CHECKING # LOANS # SAVINGS #
BANK: PH: ( ) - CONTACT :
CHECKING # LOANS # SAVINGS #

TRADES

VENDOR

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2.
3.
4.

 PHONE

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 CONTACT/ACCT NO.




OWNERS & OFFICERS

OWNERS & OFFICERS
STOCK %
NAME POSITION: ADDRESS:
CITY: ST: ZIP:
HOME PH:   -
SOC. SEC:    - -		 STOCK %
NAME 
POSITION:
ADDRESS:
CITY: ST: ZIP:
HOME PH:   -
SOC. SEC:    - -

I / We have recently made application to Media Capital for the leasing and financing of certain equipment. In accordance with their standard procedure, they will be conducting an investigation of me / us on information I have provided. All information provided will be treated by  Media Capital  in strict confidence its source and contents will not be divulged and no responsibility therefore is attached to the bank, financial institution or trade reporting.

SIGNED:__________________________TITLE:____________DATE:____________

 

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