LYNNRAY FINANCIAL
CORPORATION CREDIT APPLICATION
5696 Peachtree
Parkway, Suite J, Norcross, Georgia 30092
LESSEE (Legal Name)
_______________________________________________________DATE________________
ADDRESS _____________________________________________________________________________________
PHONE ________________FAX
________________________FEDERAL TAX ID # ________________
BUSINESS
TYPE (Circle
one) Corporation Proprietorship
Partnership YEARS IN BUSINESS _______
BANK
_____________________________PH ______________________CONTACT
__________________________
CHECKING ACCOUNT
#_________________________ DO YOU HAVE A LOAN HISTORY HERE?___________
(A
lease is a good reference)
COMPANY
_________________________________ PH _______________________ ACCT#
__________________
COMPANY
_________________________________ PH _______________________ ACCT#
__________________
COMPANY
_________________________________PH
______________________CONTACT__________________
COMPANY_________________________________PH_______________________CONTACT___________________
LEGAL NAME
___________________________________________ SOCIAL SECURITY #
___________________
ADDRESS
_____________________________________________________________Phone
__________________
LEGAL NAME
___________________________________________SOCIAL SECURITY #
_____________________
ADDRESS
_____________________________________________________________Phone
__________________
EQUIPMENT
DESCRIPTION _________________________________
COST_________________
VENDOR
_____________________________________________________ CONTACT
________________________
VENDOR
PHONE_____________________________ DESIRED LEASE TERM 24
36 48 60 Months
By
signing below, the undersigned individual, who is either a principal of
the credit applicant or a personal guarantor of its obligations, provides
written instruction to Lynnray Financial Corporation or its designee (and any
assignee or potential assignee thereof) authorizing review of his /her
personal credit profile from a national credit bureau. Such authorization
shall extend to obtaining a credit profile in considering this application and
subsequently for the purposes of update, renewal or extension of such
credit or additional credit and for reviewing or collecting the resulting
account. A photostat or facsimile copy of this authorization shall be
valid as the original. By signature below, I/we affirm my/our identity as
the respective individual/s identified in the above application.
This
is also authorization to release Bank and company credit reference information
to Lynnray Financial Corporation.
SIGNED
________________________________________________________TITLE
_________________________
SIGNED
________________________________________________________TITLE__________________________