| Applicant Personal Info |
| First |
| MI
| Last
| |
|
| Home Phone |
|
Cell Phone |
|
| Date of Birth |
|
Email Address |
|
| Soc Sec # |
|
Driver's License # |
|
| Have you ever filed for bankruptcy? |
Yes
No
If Yes, date filed
|
| Marital Status |
Married
Single
Divorced
Other
|
| # of Dependents |
|
| Filing Status |
Primary
Joint
If Joint, Primary Applicant's Name
|
|
|
Address/ Home Information |
| Home Street Address |
|
|
| City |
|
State Zip |
Ownership |
Own
Rent
Parents/Relatives
Other
|
| Years at this address |
|
Monthly Payment |
|
| Years at previous address |
|
| If you own, is there a 2nd mortgage? |
Yes
No
|
| Balance on 1st Mortgage |
|
Balance on 2nd Mort. |
|
|
|
Employment Information |
| Employment Status |
Self Employed
Full Time
Part Time
Other
|
| Employer |
|
|
| City |
|
State Zip |
| Position |
|
|
| Business Phone |
|
Supervisor |
|
| Years at this employer |
|
Gross Monthly Income |
|
| Prior Employer |
|
Years There |
|
|
| Equipment |
| Vendor |
|
Phone |
|
| Contact |
|
|
| Equipment |
New
Used
Reconditioned |
|
| Manufacturer and Model |
| |
| Sale Price |
|
Down Payment
Amount Available |
|
Remaining Amount
To Be Financed |
|
| |
| Lease Term
12
24
36
48
60
Other /No. of Months:
|
| Preferred Buyout $1.00
10%
|
|
By placing your initials in this box and submitting this form you agree to the following terms:
"I hereby authorize Southern Yankee Bar-B-Q or any credit bureau or other investigative agency employed by Southern Yankee Bar-B-Q to investigate the references herein listed or statements or other data obtained from me or from any other person pertaining to my credit and financial responsibility." |
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Applicant-Lessee authorizes lessor to obtain such information as may be required concerning the above statements within the framework of the Fair Credit Reporting Act & warrants that the credit information and all
financial statements submitted by the applicant to Lessor are true, correct,
& complete. Applicant understands the Lessor is relying on this Lease
Application and financial statements submitted by the Applicant in making
its decision whether to enter into a Lease Agreement. Applicant agrees to
inform the Lessor immediately of any matter that will cause a significant
change in the Applicant's financial condition. Applicant agrees that the
applicant and any other information submitted remain the property of the
Lessor whether or not the Lease is granted.
By signing above, the undersigned individual, who is either a principal of
the credit applicant or a guarantor of its obligations, provides this
written instruction to the above referenced Lessor/Secured Party, its
nominees or assigns, authorizing review of his/her personal credit profile
from a national credit bureau. Such authorization shall extend to obtaining
a credit profile in consideration of the application and subsequently for
the purpose of update, renewal, or extension of such credit or additional
credit and for reviewing and collecting the resulting account. A
electronic, photo static, or facsimile copy of this Authorization shall be
as valid as the original. By signing below, I/we affirm our identity as the
respective individuals identified in the related application.
The authority applies to any designee or assigns.
THIS APPLICATIONS DOES NOT OBLIGATE THE LESSOR OR THE APPLICANT TO ENTER
INTO A LEASE AGREEMENT
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