Company Information
(The items in bold are required fields)
Ownership Information
(The items in bold are required fields)
Equipment Information
(The items in bold are required fields)
Terms of Submission (Check the Business
Purposes Box, Enter Name and Date)
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Business Purposes
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The undersigned represents that all information provided
with this Application is true and correct and hereby
authorizes Dick Clark Associates, Inc. to obtain from third
parties information Lessor deems necessary to arrive at a
decision regarding this Application. Applicant certifies to
Dick Clark Associates, Inc. that it is applying for credit
for business purposes, and not for personal, family use. |
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Credit Information Release
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The undersigned individual(s),
as principal(s) of and/or guarantor(s) for the applicant,
recognizing that his or her individual credit history may be
a factor in the evaluation of the credit of the applicant,
hereby consents to and authorizes the above named business
credit provider and any assignee, lender or funding service
that may be utilized to obtain and use a consumer credit
report on the undersigned, now and from time to time, as may
be needed in the credit evaluation and review process. I
(we) specifically consent that this information may be
transmitted via the internet and waive any right or claim I
(we) would otherwise have under Fair Credit Reporting Act in
the absence of this continuing consent. Fax, electronic
submission, or copy of this authorization valid as original.
Type your full name here:
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Date:
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By submitting this application I verify that
I have read and agreed to the above statements of "Business
Purposes" and "Credit Information Release" and that the
information provided is true. |
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