KEY CREDIT APPLICATION

 

LESSEE CO./ DBA ________________________________________________________________________

 

STREET _________________________________________ PHONE_____________ FAX _______________

 

CITY ________________________ COUNTY________________ STATE ____________ ZIP _____________

 

INSTALLATION ADDRESS _________________________________________________________________

 

CONTACT __________________________ LEASE SIGNOR/TITLE _________________________________

 

LESSEE IS:  (    ) CORP.(    )  PARTNERSHIP (    ) SOLE PROPRIETOR     FED I.D. # ___________________

YEARS IN                   YEARS UNDER                                  TYPE

BUSINESS _____  CURRENT OWNERSHIP _____  OF BUSINESS _________________________________

 

HAS PRINCIPAL OR COMPANY FILED BANKRUPTCY IN THE LAST 10 YEARS?   (    ) YES      (    ) NO

 PRINCIPAL (S) OR GUARANTOR (S)

 

___________________________________________________________________________

(NAME)       (TITLE/%OWNERSHIP)   (HOME ADDRESS & PHONE)   (DATE OF BIRTH)  (SOCIAL SECURITY #)

 

______________________________________________________________________________________

(NAME)       (TITLE/%OWNERSHIP)   (HOME ADDRESS & PHONE)   (DATE OF BIRTH)  (SOCIAL SECURITY #)

 BANK REFERENCES (NEED AT LEAST 2 YEAR HISTORY, PLEASE)

 

______________________________________________________________________________________

(NAME)                  (PHONE)     (ACCOUNT NUMBER/TYPE)    (DATE OPENED) (CONTACT NAME)   

 

______________________________________________________________________________________ 

(NAME)                  (PHONE)     (ACCOUNT NUMBER/TYPE)    (DATE OPENED) (CONTACT NAME)   

  

LOAN HISTORY PAST OR PRESENT ________________________________________________________

                                                                     (BANK)                (PHONE)        (LOAN NUMBER)        (AMOUNT)

TRADE REFERENCES

 _____________________________________________________________________________________

(CO. NAME)                    (PHONE)                                        (CONTACT NAME)         (ACCT. #)

 

_____________________________________________________________________________________

(CO. NAME)                    (PHONE)                                        (CONTACT NAME)         (ACCT. #)

 

_____________________________________________________________________________________

(CO. NAME)                    (PHONE)                                        (CONTACT NAME)         (ACCT. #)

CREDIT RELEASE:

I hereby authorize the release of all credit information to and consent to the obtaining and use of my consumer credit report by Key Credit Corp. and its assigns/potential assigns at anytime, for obtaining credit, and applicable account maintenance. I understand that this information may be transmitted via Internet and/or fax machine. I consent to the photocopying of my drivers license for verification purposes in connection with a commercial lease transaction. I also consent to receiving unsolicited faxes and emails wherein Key Credit Corp. will advertise its services. The Patriot Act now requires Date of Birth.

  X __________________            X  ____________________

  APPLICANTS SIGNATURE                                            APPLICANTS SIGNATURE

DESCRIPTION OF EQUIPMENT

 

EQUIPMENT COST ___________________  TERM _______ MONTHS      PURCHASE OPTION ___________

VENDOR ____________________________________ PHONE _______________ FAX ________________ 

ADDRESS _____________________________________________ CONTACT _______________________

Key Credit Corp.   Fax: 800-261-7826,   Voice 800-344-9922         

Please FAX Completed Application to: 813-982-8283