EQUIPMENT FINANCE GROUP MUNICIPAL LEASING 158 Las Banderas * Suite 255 * Solana Beach * CA * 92075 Telephone: 858.847.0000 * Fax: 858.847.0100 E-mail: sales@canfieldcapital.com  Toll Free 866.367.7393
Legal Name of Entity
Address			City	State	Zip
Contact			Title
Phone		Fax		E-mail
Dollar Amount			Type of Equipment
Supplier of Equipment			Phone
Circule one term	12	24	36	48	60	Other
Circule one Payments	Monthly	Quarterly	Semi-Annual	Annual	Other
Request Delivery Date
Authorized Signor				Title
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