| Equipment Information (Quantity, Model, Extras) |
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| Approximate Total Equipment Cost?($) |
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| Name: |
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| Company: (Optional) |
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| Complete Address: (street, city, state, zip) |
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| Phone Number |
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| Fax? (Optional) |
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| Social Security Number |
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| Email Address: |
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| Occupation? |
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| Years in Business? (If less than a year co-signor might be needed) |
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| The persons(s) supplying the above information certifies to StenoTech, Inc. that it is true and correct. The Owners/Partners/Guarantors authorize StenoTech, Inc. to investigate his/her personal credit status, including consumer credit reports. |
I agree
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