Credit Application

Print out the following form and close this window
Then mail or fax it to:

Taylor Dakota Restaurant Equipment
Tom Kambeitz - President
517 Airport Road • Bismarck, ND 58504
Phone: 1-800-279-6151 • Fax: 1-701-223-0028
E-mail: sales@therestaurantoutfitter.com

 

Lease Information

Total Equipment Costs:

Equipment:

Term of Lease:

Monthly Payment Desired:

Buyout Option:
$1 Buyout       10% Fair Market Value

 

Business Information

Business Name:

Contact Name:

Title:

Phone:

FAX:
 

Email:

Address:

City:

State:

ZIP Code:

Type of Business:
Corporation
Partnership
Proprietorship

Years in Business:

 

Nature of Business:

 

Credit Information

Bank:

Bank:

Account Number:

Account Number:

Contact Name:

Contact Name:

Phone:

Phone:


Trade Reference:

Address:

City:

State:

ZIP Code:

Phone:

Trade Reference:

Address:

City:

State:

ZIP Code:

Phone:

Trade Reference:

Address:

City:

State:

ZIP Code:

Phone:


Principle's Name:

Social Security Number:

Address:

City:

State:

ZIP Code:

Principle's Name:

Social Security Number:

Address:

City:

State:

ZIP Code:

Most Banks and Lenders will not release credit information without customer approval.
"I hereby authorize the release of credit and financial information."

By: _____________________________________________ Date: ________________