Indian Nation Lease-Finance Form


*Name of Indian Nation / Tribe
*City
*Street Address
*State
*Zip Code
*Contact First Name
*Contact Last Name
*Title
*Name of Tribe Officer Executing the Lease
*Phone (Include Area Code)
*Fax (Include Area Code)
*E-mail Address
*Web Site
*Equipment Description
*Division Using Equipment
*Proposed Location of Equipment
*Equipment Essential to Tribe (Explain)
*How Many Years Will It Be Used?
*Approximate Delivery Date (If Known-dd/mm/yy)
*Vendor/Supplier Company Name
*Vendor City
*Vendor Street Address
*Vendor State
*Vendor Zip Code
*Vendor Phone (Include Area Code)
*Vendor Fax (Include Area Code)
*Vendor E-mail Address
*Vendor Web Site
*Muncipality Bond Rating (If Known)
*Lease Term Desired (In Years)
*Payment Structure Desired
*Advance Payments (If Any)
*Arrears Payments (If Any)
Competition (if Known)
*Comments/Special Situations
*Date Annual Report Available (dd/mm/yy)
	* Denotes a required field