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Lease Application
with Credit Authorization Form
Instructions:
1. Download form,
fill out, and fax to: (949) 727-3722,
or 2. Type out the form below, print, and fax to:
(949) 727-3722.
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Company Information
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Company Name
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Billing
Address
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Nature
of Business
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Physical
Equipment Location (If different from above)
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Principal
Information |
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Banking
Relationship |
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Trade Relationships / Lease & Loan References |
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Equipment
Information |
Vendor
Name
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Contact
Person
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Address
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Requested
Terms |
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Signature
_____________________________________________________
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Date:
___________ |
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Please Fax to: (949) 727-3722
Lessee
certifies that all credit and financial information is true
and correct and authorizes Lessor and/or any prospective
creditor to investigate Lessee's credit worthiness and disclose
information and investigation results to each other. I understand
that I have the right to a written statement of reasons
if my application is declined and I ask for such a statement.
The Federal Equal Credit Opportunity Act prohibits creditors
from discriminating against credit applicants on the basis
of race, creed, sex, or marital status. Lessee gives permission
to lessor to transmit this application via the internet,
if such transmission is required as part of the application
process.
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Credit Authorization:
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I/WE authorize Lessor to make whatever credit inquiries that
is deemed necessary in connection with this lease application.
I/WE authorize and instruct any person, banking officer, vendor
or consumer reporting agency to compile and furnish to Lessor
any information that is required and acknowledge that such
information, along with the application, shall remain Lessor's
property whether or not the lease transaction is approved.
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Applicant:
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By:
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Title:
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Company
Name:
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Note:
Use full legal name(s). Signature(s) must be only those
duly authorized corporate officer, partner or proprietor,
with title indicated.
If
this authorization is for personal bank checking and/or
loan account ratings, the signatures below hereby empower
Pacifica Capital and/or it's assignees to obtain those ratings.
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Signature
_____________________________________________________
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Date:
___________ |
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Signature
_____________________________________________________
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Date:
___________ |
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Signature
_____________________________________________________
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Date:
___________ |
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Instructions:
1. Download form,
fill out, and fax to: (949) 727-3722 or
2. Fill out the below, print, and fax to: (949) 727-3722.
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