WWW.TEAMFINANCIALGROUP.COM
PRESENTS
Enclosed In This Packet:
• Team Financial Group History
• Top 10 Reasons to Work with Team Financial Group
• Financing Products and Benefits
• Equipment Financing Process
• Credit Information Checklist
• Application-Standard
• Application-Municipal
PHONE: (616) 735-2393 FAX: (616) 735-2392
EMAIL: INFO@TEAMFINANCIALGROUP.COM
Team Financial Group, Inc. was created to provide convenient, efficient and creative financing alternative to assist vendors and
businesses with financing of capital equipment. The company was founded in May of 2001 by Tim Maczka and Joe Smaby, due in
part to the Fifth Third and Old Kent merger. As part of the merger, Fifth Third made the strategic decision to exit both the vendor and
small ticket end-user leasing business, leaving a void for many vendors and clients. To fill that void, Team Financial
Group was formed. Our focus is to provide commercial businesses flexible financing solutions for the acquisition of depreciable assets.
Team Financial Group has the expertise, products and structuring capabilities to handle commercial leases and loans from
$5,000 to $5,000,000.
Team Financial Group, Inc.’s commitment to developing long-term relationships is reinforced by service guarantees offered to
our vendors and clients. Some of our major strengths and keys to success include:
• Common Sense Credit Policy (outside the box thinking and local decision making)
• Localized, Personalized Service
• Full Service Finance Company, Servicing 100% of Originations
• Consistent, Automated and Efficient Processing
• Product and Lease Industry Knowledge
• Consultative, Value-Added Approach to “Relationship Selling”
• Extensive Experience, Knowledge of Financial Services Industry
• Competitive Pricing and Products
• Flexible Terms and Structure
The core group of employees has over 100 years of experience in the financial services arena with the majority of tenure being with
the former Old Kent Financial. The experience and expertise of the group includes: Retail Banking, Business Banking, Corporate
Banking Management, Sales and Marketing, and Equipment Leasing. Below is the management team for Team
Financial Group, Inc.
Tim Maczka-President and CEO
• 26 years Senior Management experience with Old Kent Financial
• Recent: SVP-Dealer Services, responsible for Wholesale and Retail Dealer Lending
• Past: SVP-(Corporate Banking, Business Banking, Discount Leasing, Consumer Lending)
Joe Smaby– Vice President of Sales and Marketing
• 14 years experience with Old Kent Financial
• Recent: VP-Corporate Sales Manager-Equipment Leasing (Old Kent Leasing)
• Past: VP-Regional Sales Manager-Retail and Business Banking
Mike Schmidt-Vice President, Director of Underwriting
• 21 years of banking experience with Fifth Third Bank/Old Kent Financial
Matt Maczka-Vice President, Leasing Specialist
• 9 years in operations and equipment finance in the construction industry
Tanya Schulz-Accounting Manager
• 14 years accounting/financial services experience
Kara Wildern-Operations Manager
• 9 years operations/accounting experience
Carol Berry-Collection Specialist
• 11 years collection experience
Michelle Gephart-Inside Sales
• 22 years sales support/billing experience
WWW.TEAMFINANCIALGROUP.COM
1. Turnaround Time
Less than 24 hours for credit response once complete application is received.
Speak with a live person or receive a return call prior to the end of same business day
Resolution or response to all customer service inquiries within 24 hours
2. Performance Guarantee
If we don’t deliver on the above turnaround times, we pay $25 for each occurrence
3. Free Comparison with Any Competitor Quote
Let us look at any vendor quotes before you sign, we’ll either beat it or tell you to go with that great deal
4. Origination Fee Reduced by $100 on First Lease
5. Local, Proven Service
Located in Grand Rapids, servicing Mid-West and Beyond.
Over 70 combined years of working with Mid-West clients with the former Old Kent Financial Corp.
6. Proven Expertise in all Aspects of Leasing
Tax (55-540), Legal (Article 2A & 9), Accounting (FASB 13)
A properly structured lease can improve financial ratios, balance sheets, and cash flow while conserving other credit
sources
7. Focused on Relationship, not Transaction
Our product offering coupled with vast expertise allows us to provided consultative service to help you meet your
financial goals
8. Easy Application and Documentation Processes
Applications taken via fax, email, or telephone
9. Convenient
10 Master Leases and Pre-approved Credit Lines Available
Let Team Financial Group help your team
save money and time. Call us today!
Let us work with you on your next equipment acquisition. Team Financial Group’s product offering coupled with our vast
expertise allows us to provide consultative service to help you meet your financial goals. We offer the speed you need to get
business done and the payment flexibility to fit your budget.
PHONE: (616) 735-2393 FAX: (616) 735-2392
EMAIL: INFO@TEAMFINANCIALGROUP.COM
WWW.TEAMFINANCIALGROUP.COM
$1 Out Purchase Option:
At the end of the term if the lease is current, the lessee may purchase the equipment for $1.00. This type of
lease is treated as a conditional sale for tax and accounting purposes.
Fixed Purchase Option (usually 10% to 20%):
The purchase price is fixed at the start of the lease and represents the maximum a lessee will pay if they
choose to purchase the equipment. The Fixed PO offers lower payments than the $1 Out lease and is
typically used when long-term ownership is a possibility. Equally important, rent payments may be
expensed for tax purposes and, in some situations, for book accounting also. This provides greater control
and flexibility for lessees while saving tax dollars.
Fair Market Value (FMV) Purchase Option:
At the end of the lease, the purchase price is negotiated between lessee and the lessor. Typically used for
lessees that anticipate trading up or purchasing replacement equipment at the end of the lease. The FMV
lease offers the lowest monthly payment for the lessee compared to the $1 Out and Fixed PO. Rent
payments may be expensed for tax purposes and possibly for book accounting.
Municipal Leasing:
Typically, a Municipal Lease is structured as a $1 Out (Conditional Sale). By doing so, the transaction then
can qualify as TAX EXEMPT, resulting in attractive pricing for the municipality. By selling the lease
option to Municipalities, you can more easily overcome cap-ex restraints and simplify the process for your
client. Non-appropriation language is included in the “Terms and Conditions” of our lease documents.
Furthermore, TEAM does not require financial statements, board minutes or an attorney opinion letter for
transactions under $100,000.
Other Leasing Products Available:
• T.R.A.C.: Leasing for commercial vehicles
• Non-Profit 501-C: Financing for churches, private schools, hospitals and other not for profit companies
• 100% financing, including tax, shipping, delivery, software and other soft costs associated with setting up
new equipment
• Little to no up-front cost. One or two payments due at signing vs. all of the equipment cost or a substantial
down payment is generally required with a loan
• Flexibility to choose a monthly payment amount that fits your company’s budget
• With certain structures, the lease payment is tax deductible to help your company control expenses for tax
purposes and potentially saving money
• Seasonal payments are available if necessary to match the revenue generated from the equipment to the
expense
• Equipment additions and extras now with a few dollars more per month, less up-front investment for more
equipment
Keep bank lines of credit available for working capital needs
PHONE: (616) 735-2393 FAX: (616) 7323
EMAIL: INFO@TEAMFINANCIALGROUP.COM
WWW.TEAMFINANCIALGROUP.COM
2
Documentation prepared by TEAM and executed by customer.
Documentation can be sent to you or your customer, YOU DECIDE!
3
Funding for the transaction will be disbursed same day or within 24
hours of receipt of the completed documents!
PHONE: (616) 735-2393 FAX: (616) 735-2392
EQUIPMENT FINANCING PROCESS AT
TEAM FINANCIAL GROUP
ITS AS EASY AS...
1
Submit a credit application and other items necessary to
Team Financial Group by fax at (616) 735-2392 or online at
Info@teamfinancialgroup.com. Decisions will be made that day or
within 24 hours!
TEAM
FINANCIAL GROUP, INC.
Phone: (616) 735-2393
Fax: (616) 735-2392
Email: info@teamfinancialgroup.com
Web: www.teamfinancialgroup.com
LEASE APPLICATION
Information on Lessee
Company Name (Important to list legal name) State Registered
Address: Sales Previous Year Projected Sales Current
Telephone Number Fax Number Contact Person/Title E-Mail Address
Type of Business:
[ ] Municipality [ ] Partnership [ ] Non Profit [ ] Corporation [ ] Sub S [ ] Proprietorship [ ] LLC
Information on Owner(s) (Attach separate list if necessary)
(1) Name Own/Rent % of Business Social Security Number
Home Address City State Zip code
Home Phone Number Home Value Mortgage Amount Self-Employed W2
(2) Name Own/Rent % of Business Social Security Number
Home Address City State Zip code
Home Phone Number Home Value Mortgage Amount Self-Employed W2
Credit References – Two Year History (Attach separate list if necessary)
Name of Supplier Contact Person Telephone Number
Address of Supplier
I (we) warrant this information supplied to Team Financial Group, Inc. to be true and understand said information will be relied upon by Lessor (or its assigns) in furnishing
credit to applicant and I (we) hereby authorize Lessor, and/or any credit bureau or other investigative agency employed by such person to investigate the references supplied
or statement or other data obtained from me (us) pertaining to my (our) credit and financial responsibility. NOTICE: The federal Equal Credit Opportunity Act prohibits
creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to
enter into a binding contract), because all or a part of the applicant’s income derives from any public assistance program, or because the applicant has in good faith exercised
any right under the Consumer Credit Protection Act. The federal agency tat administers compliance with this law concerning this creditor is Federal Trade Commission,
Equal Credit Opportunity, Washington D.C. 20580. If your application is denied you have the right to a statement of specific reasons for such denial within 30 days after you
send a written request to: Joseph Smaby, Team Financial Group 3391 Three Mile Rd NW Grand Rapids, MI 49534, 616-735-2393. Please note that your request must be
received in writing at the above address within 60 days after credit is denied.
______________________________________________ ______________________________________ _____________________
Signature of Authorized Individual Title Date
Signature of Authorized Individual Title Date
TEAM
FINANCIAL GROUP, INC.
Phone: (616) 735-2393
Fax: (616) 735-2392
Email: info@teamfinancialgroup.com
SHORT-FORM MUNICIPAL CREDIT APPLICATION
Complete fully and fax to Team Financial at 616-735-2392
Vendo ____
Sales Rep _
Legal Name of the Lessee: ___________________________________________________________
Address: _________________________________________________________________________
City, State, Zip:____________________________________________________________________
ContactPerson:CoCoCCoCConCCoCcc__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Title: _____________________________
Phone:__________________________Fax: ___________________Email: ________________________
AlternateContactPerson:______________________________ Title: ___________________________ Phone:
Date Municipal Entity was Established: ____________
TRANSACTION INFORMATION
Total Cost of the Equipment:
Down Payment:
Trade - In:
Term:(years)
Delivery Date:
Payment: $
Amount to Finance: Payments: Monthly Annual Semi-Annual Quarterly
1. Is the equipment replacing existing equipment? Yes / No
2. If yes, please state how long the municipality has used the current equipment and the reason for purchasing the new equipment:
3. Do you currently owe or are you making lease payments on your existing equipment that is being replaced? Yes / No
4. If yes, please describe in detail what agreement (if any) you have worked out with the vendor concerning the existing equipment
that is being replaced: ___________________________________________________________________________________
5. If billing address is different than above, please provide here:___________________________________________________
6. Please describe in detail why the lessee needs the equipment and the essential use the equipment will provide:
7. From what fund will the rental payments be made? General or Special (Please specify) _____________________
8. Haveyoueverbeenindefaultornon-appropriatedonamunicipallease?Yes/No
9. Has the entity issued or plans to issue > $30,000,000 in long term debt during the calendar year of this purchase? Yes / No
FINANCIAL INFORMATION
Please accurately fill out the requested fund information for either the general fund or the special fund from which the payments
will be made. Alternatively, you may fax a copy of your income statement and balance sheet to Team Financial at 616-735-2392.
Current Year 20______ Prior year
Total Revenues: $ $
Total Expenditures: $ $
Fund Balances: $ ____________________ $____________________
INSURANCE INFORMATION
Name of Insurance Provider ______________________ Name of Agent or Contact ____________
Phone Number of Provider _______________________ Fax Number of Provide ______________

Team Financial Group

  • 1.
    WWW.TEAMFINANCIALGROUP.COM PRESENTS Enclosed In ThisPacket: • Team Financial Group History • Top 10 Reasons to Work with Team Financial Group • Financing Products and Benefits • Equipment Financing Process • Credit Information Checklist • Application-Standard • Application-Municipal PHONE: (616) 735-2393 FAX: (616) 735-2392 EMAIL: INFO@TEAMFINANCIALGROUP.COM
  • 2.
    Team Financial Group,Inc. was created to provide convenient, efficient and creative financing alternative to assist vendors and businesses with financing of capital equipment. The company was founded in May of 2001 by Tim Maczka and Joe Smaby, due in part to the Fifth Third and Old Kent merger. As part of the merger, Fifth Third made the strategic decision to exit both the vendor and small ticket end-user leasing business, leaving a void for many vendors and clients. To fill that void, Team Financial Group was formed. Our focus is to provide commercial businesses flexible financing solutions for the acquisition of depreciable assets. Team Financial Group has the expertise, products and structuring capabilities to handle commercial leases and loans from $5,000 to $5,000,000. Team Financial Group, Inc.’s commitment to developing long-term relationships is reinforced by service guarantees offered to our vendors and clients. Some of our major strengths and keys to success include: • Common Sense Credit Policy (outside the box thinking and local decision making) • Localized, Personalized Service • Full Service Finance Company, Servicing 100% of Originations • Consistent, Automated and Efficient Processing • Product and Lease Industry Knowledge • Consultative, Value-Added Approach to “Relationship Selling” • Extensive Experience, Knowledge of Financial Services Industry • Competitive Pricing and Products • Flexible Terms and Structure The core group of employees has over 100 years of experience in the financial services arena with the majority of tenure being with the former Old Kent Financial. The experience and expertise of the group includes: Retail Banking, Business Banking, Corporate Banking Management, Sales and Marketing, and Equipment Leasing. Below is the management team for Team Financial Group, Inc. Tim Maczka-President and CEO • 26 years Senior Management experience with Old Kent Financial • Recent: SVP-Dealer Services, responsible for Wholesale and Retail Dealer Lending • Past: SVP-(Corporate Banking, Business Banking, Discount Leasing, Consumer Lending) Joe Smaby– Vice President of Sales and Marketing • 14 years experience with Old Kent Financial • Recent: VP-Corporate Sales Manager-Equipment Leasing (Old Kent Leasing) • Past: VP-Regional Sales Manager-Retail and Business Banking Mike Schmidt-Vice President, Director of Underwriting • 21 years of banking experience with Fifth Third Bank/Old Kent Financial Matt Maczka-Vice President, Leasing Specialist • 9 years in operations and equipment finance in the construction industry Tanya Schulz-Accounting Manager • 14 years accounting/financial services experience Kara Wildern-Operations Manager • 9 years operations/accounting experience Carol Berry-Collection Specialist • 11 years collection experience Michelle Gephart-Inside Sales • 22 years sales support/billing experience
  • 3.
    WWW.TEAMFINANCIALGROUP.COM 1. Turnaround Time Lessthan 24 hours for credit response once complete application is received. Speak with a live person or receive a return call prior to the end of same business day Resolution or response to all customer service inquiries within 24 hours 2. Performance Guarantee If we don’t deliver on the above turnaround times, we pay $25 for each occurrence 3. Free Comparison with Any Competitor Quote Let us look at any vendor quotes before you sign, we’ll either beat it or tell you to go with that great deal 4. Origination Fee Reduced by $100 on First Lease 5. Local, Proven Service Located in Grand Rapids, servicing Mid-West and Beyond. Over 70 combined years of working with Mid-West clients with the former Old Kent Financial Corp. 6. Proven Expertise in all Aspects of Leasing Tax (55-540), Legal (Article 2A & 9), Accounting (FASB 13) A properly structured lease can improve financial ratios, balance sheets, and cash flow while conserving other credit sources 7. Focused on Relationship, not Transaction Our product offering coupled with vast expertise allows us to provided consultative service to help you meet your financial goals 8. Easy Application and Documentation Processes Applications taken via fax, email, or telephone 9. Convenient 10 Master Leases and Pre-approved Credit Lines Available Let Team Financial Group help your team save money and time. Call us today! Let us work with you on your next equipment acquisition. Team Financial Group’s product offering coupled with our vast expertise allows us to provide consultative service to help you meet your financial goals. We offer the speed you need to get business done and the payment flexibility to fit your budget. PHONE: (616) 735-2393 FAX: (616) 735-2392 EMAIL: INFO@TEAMFINANCIALGROUP.COM
  • 4.
    WWW.TEAMFINANCIALGROUP.COM $1 Out PurchaseOption: At the end of the term if the lease is current, the lessee may purchase the equipment for $1.00. This type of lease is treated as a conditional sale for tax and accounting purposes. Fixed Purchase Option (usually 10% to 20%): The purchase price is fixed at the start of the lease and represents the maximum a lessee will pay if they choose to purchase the equipment. The Fixed PO offers lower payments than the $1 Out lease and is typically used when long-term ownership is a possibility. Equally important, rent payments may be expensed for tax purposes and, in some situations, for book accounting also. This provides greater control and flexibility for lessees while saving tax dollars. Fair Market Value (FMV) Purchase Option: At the end of the lease, the purchase price is negotiated between lessee and the lessor. Typically used for lessees that anticipate trading up or purchasing replacement equipment at the end of the lease. The FMV lease offers the lowest monthly payment for the lessee compared to the $1 Out and Fixed PO. Rent payments may be expensed for tax purposes and possibly for book accounting. Municipal Leasing: Typically, a Municipal Lease is structured as a $1 Out (Conditional Sale). By doing so, the transaction then can qualify as TAX EXEMPT, resulting in attractive pricing for the municipality. By selling the lease option to Municipalities, you can more easily overcome cap-ex restraints and simplify the process for your client. Non-appropriation language is included in the “Terms and Conditions” of our lease documents. Furthermore, TEAM does not require financial statements, board minutes or an attorney opinion letter for transactions under $100,000. Other Leasing Products Available: • T.R.A.C.: Leasing for commercial vehicles • Non-Profit 501-C: Financing for churches, private schools, hospitals and other not for profit companies • 100% financing, including tax, shipping, delivery, software and other soft costs associated with setting up new equipment • Little to no up-front cost. One or two payments due at signing vs. all of the equipment cost or a substantial down payment is generally required with a loan • Flexibility to choose a monthly payment amount that fits your company’s budget • With certain structures, the lease payment is tax deductible to help your company control expenses for tax purposes and potentially saving money • Seasonal payments are available if necessary to match the revenue generated from the equipment to the expense • Equipment additions and extras now with a few dollars more per month, less up-front investment for more equipment Keep bank lines of credit available for working capital needs PHONE: (616) 735-2393 FAX: (616) 7323 EMAIL: INFO@TEAMFINANCIALGROUP.COM
  • 5.
    WWW.TEAMFINANCIALGROUP.COM 2 Documentation prepared byTEAM and executed by customer. Documentation can be sent to you or your customer, YOU DECIDE! 3 Funding for the transaction will be disbursed same day or within 24 hours of receipt of the completed documents! PHONE: (616) 735-2393 FAX: (616) 735-2392 EQUIPMENT FINANCING PROCESS AT TEAM FINANCIAL GROUP ITS AS EASY AS... 1 Submit a credit application and other items necessary to Team Financial Group by fax at (616) 735-2392 or online at Info@teamfinancialgroup.com. Decisions will be made that day or within 24 hours!
  • 6.
    TEAM FINANCIAL GROUP, INC. Phone:(616) 735-2393 Fax: (616) 735-2392 Email: info@teamfinancialgroup.com Web: www.teamfinancialgroup.com LEASE APPLICATION Information on Lessee Company Name (Important to list legal name) State Registered Address: Sales Previous Year Projected Sales Current Telephone Number Fax Number Contact Person/Title E-Mail Address Type of Business: [ ] Municipality [ ] Partnership [ ] Non Profit [ ] Corporation [ ] Sub S [ ] Proprietorship [ ] LLC Information on Owner(s) (Attach separate list if necessary) (1) Name Own/Rent % of Business Social Security Number Home Address City State Zip code Home Phone Number Home Value Mortgage Amount Self-Employed W2 (2) Name Own/Rent % of Business Social Security Number Home Address City State Zip code Home Phone Number Home Value Mortgage Amount Self-Employed W2 Credit References – Two Year History (Attach separate list if necessary) Name of Supplier Contact Person Telephone Number Address of Supplier I (we) warrant this information supplied to Team Financial Group, Inc. to be true and understand said information will be relied upon by Lessor (or its assigns) in furnishing credit to applicant and I (we) hereby authorize Lessor, and/or any credit bureau or other investigative agency employed by such person to investigate the references supplied or statement or other data obtained from me (us) pertaining to my (our) credit and financial responsibility. NOTICE: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract), because all or a part of the applicant’s income derives from any public assistance program, or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency tat administers compliance with this law concerning this creditor is Federal Trade Commission, Equal Credit Opportunity, Washington D.C. 20580. If your application is denied you have the right to a statement of specific reasons for such denial within 30 days after you send a written request to: Joseph Smaby, Team Financial Group 3391 Three Mile Rd NW Grand Rapids, MI 49534, 616-735-2393. Please note that your request must be received in writing at the above address within 60 days after credit is denied. ______________________________________________ ______________________________________ _____________________ Signature of Authorized Individual Title Date
  • 7.
    Signature of AuthorizedIndividual Title Date TEAM FINANCIAL GROUP, INC. Phone: (616) 735-2393 Fax: (616) 735-2392 Email: info@teamfinancialgroup.com SHORT-FORM MUNICIPAL CREDIT APPLICATION Complete fully and fax to Team Financial at 616-735-2392 Vendo ____ Sales Rep _ Legal Name of the Lessee: ___________________________________________________________ Address: _________________________________________________________________________ City, State, Zip:____________________________________________________________________ ContactPerson:CoCoCCoCConCCoCcc__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Title: _____________________________ Phone:__________________________Fax: ___________________Email: ________________________ AlternateContactPerson:______________________________ Title: ___________________________ Phone: Date Municipal Entity was Established: ____________ TRANSACTION INFORMATION Total Cost of the Equipment: Down Payment: Trade - In: Term:(years) Delivery Date: Payment: $ Amount to Finance: Payments: Monthly Annual Semi-Annual Quarterly 1. Is the equipment replacing existing equipment? Yes / No 2. If yes, please state how long the municipality has used the current equipment and the reason for purchasing the new equipment: 3. Do you currently owe or are you making lease payments on your existing equipment that is being replaced? Yes / No 4. If yes, please describe in detail what agreement (if any) you have worked out with the vendor concerning the existing equipment that is being replaced: ___________________________________________________________________________________ 5. If billing address is different than above, please provide here:___________________________________________________ 6. Please describe in detail why the lessee needs the equipment and the essential use the equipment will provide: 7. From what fund will the rental payments be made? General or Special (Please specify) _____________________ 8. Haveyoueverbeenindefaultornon-appropriatedonamunicipallease?Yes/No 9. Has the entity issued or plans to issue > $30,000,000 in long term debt during the calendar year of this purchase? Yes / No FINANCIAL INFORMATION Please accurately fill out the requested fund information for either the general fund or the special fund from which the payments will be made. Alternatively, you may fax a copy of your income statement and balance sheet to Team Financial at 616-735-2392. Current Year 20______ Prior year Total Revenues: $ $ Total Expenditures: $ $ Fund Balances: $ ____________________ $____________________ INSURANCE INFORMATION Name of Insurance Provider ______________________ Name of Agent or Contact ____________ Phone Number of Provider _______________________ Fax Number of Provide ______________