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PFA Vendor Backed Leasing Portal

Please enter the appropriate information n equipment leasing here as it will start the leasing process and register your vendor and client to your PFA Broker #.

Date:

-- mm/dd/yy    

PFA Broker # 

PFA Broker Info:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
URL

Client Information

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
URL

Vendor Information

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL

Client Equipment List

QTY DESCRIPTION

BILLING
Purchase Order #
Account Name

SHIPPING
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
 

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Revised: February 01, 2016