Order Form Business Legal Name dba Store Number Owner's Name * First Name Last Name Business Phone * (###) ### #### Owner's Email Address * for document signing purposes Business Address * Street Address, City, State & Zip Code Referred By (Sales Representative) BITE Santa Fe Countertop Kiosk Bundle - * $94.20 per Month/per Bundle 0 1 2 3 4 5 6 3-Year Onsite Service Package - Optional * $36.05 per Month/per Bundle 0 1 2 3 4 5 6 Thank you for your interest in financing equipment. We will follow up shortly with a Lease Agreement for signature via DocuSign. Please contact us at (202) 932-4449 if you have any questions about financing.