SUBMIT A RENTAL REQUEST

Name*
First Last
Will you be the onsite contact person?*
- Yes
- No
Onsite Contact Name*
Please list the person that we would contact about the rental.
First Last
Onsite Contact Information*
Phone Email Address
Company or Organization
Email Address*
Enter Email Confirm Email
Your Phone Number*
Location of Rental*
Street Address Address Line 2 City State ZIP Code
Rental Equipment Type*
Please select the type of equipment you're interested in renting from us.
- Color Copier/MFP
- Black & White Copier/MFP
- Scanner
- Fax
- Other
Rental Usage*
Please select all that apply.
- Copy
- Print
- Scan
- Fax
What other type of equipment would you like to rent from us?*
Network Installation*
Do you need the equipment installed on your network?
- Yes
- No
IT Contact Name
First Last
IT Contact Information*
Phone Email Address
Choose an Engine Speed*
What volume/speed do you need for your rental?
Finisher/Stapling/Sorting*
Do you need any of these equipment options? Please select all that apply.
- Finisher, Stapling and Sorting
- Fax
- No Options
Paper Trays*
How many paper trays (cassettes) do you need?
Rental Start Date
Date Format: MM slash DD slash YYYY
Rental Duration
How long would you like to rent the equipment for?
Questions or Comments
Are there any details you would like to provide us?
Rent to Own Options Available
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