Form: Admin TAC

When you submit this form, an e-mail with a link is sent to your client. This link leads to another page with a form. That form will pre-populate based on the information you submitted here.
Target Page*
AuthCode

validcodes griggs1
Authorizing E-mail Address*

This is your client's e-mail address as recorded in your customer database.
Date of Agreement*
MM slash DD slash YYYY

Corresponds to "This agreement, made this____day of ____"
Lease Basis*

Corresponds to "hereby leases on a _____ Basis the following equipment..."
Lessee*

Corresponds to "...the following equipment to (Herinafter called customer)____________"
Serial Number:
What is being leased?*
Corresponds to "..agrees to lease the customer the following...to wit:______"
Installation Charge
Location of Use
Corresponds to "Said equipment shall be located and used at:_________"
Annual Fee
Corresponds to "The Customer agrees to pay Company therefore a rate of..."
Start Date
MM slash DD slash YYYY

Corresponds to "Commencing on ______"
Name
This field is for validation purposes and should be left unchanged.

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