| DATE | |
| INITIALS |
PAYOFF FORM
| LESSEE
NAME | LEASE
NUMBER | |||||||||||||
| FUNDING
SOURCE | CONTACT
PHONE | |||||||||||||
| LESSEE
CONTACT | LESSEE
PHONE | |||||||||||||
| EQUIPMENT DESCRIPTION | ||||||||||||||
| LEASE
TERM | START
DATE | MONTHLY PAYMENTS | ||||||||||||
| # OF PAYMENTS MADE | # OF PAYMENTS REMAINING | |||||||||||||
| LEASE BALANCE = MONTHLY PAYMENT X REMAINING MONTHS | $ | |||||||||||||
|
BANK PAYOFF | $ | |||||||||||||
|
LATE CHARGES | $ | |||||||||||||
|
SALES TAX - BANK PAYOFF | $ | |||||||||||||
|
FEES |
$ | |||||||||||||
|
PERSONAL PROPERTY TAX | $ | |||||||||||||
|
AMERICAN LEASING PURCHASE OPTION |
$ | |||||||||||||
|
SALES TAX ON PURCHASE OPTION | $ | |||||||||||||
|
TOTAL PAYOFF TO LESSEE: |
$ | |||||||||||||
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