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CREDIT
APPLICATION
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| CUSTOMER
INFORMATION |
|
| LEGAL COMPANY
NAME: |
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| DATE OF
APPLICATION: |
|
| PROPRIETORSHIP
PARTNERSHIP
CORPORATION |
| STREET
ADDRESS: |
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| CITY: |
|
| PROVINCE: |
|
| POSTAL CODE: |
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| *
Credit Card information below: |
| cc#:
exp. date:
cvv # |
| TELEPHONE
(incl. area code): |
|
| FAX (incl.
area code): |
|
| EMAIL: |
|
|
|
| BUSINESS
TYPE: |
| |
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| # OF
EMPLOYEES: |
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| ESTIMATED
ANNUAL RENTAL VOLUME: |
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| DATE OF
REGISTRATION/INCORPORATION: |
|
|
| PRINCIPALS |
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| NAME IN FULL: |
|
|
PARTNER |
| RESIDENTIAL
ADDRESS: |
|
|
SOLE OWNER |
| DRIVER'S
LICENSE: |
|
|
SIGNING
OFFICER |
| TELEPHONE
(incl. area code): |
|
| |
|
| NAME IN FULL: |
|
|
PARTNER |
| RESIDENTIAL
ADDRESS: |
|
|
SOLE OWNER |
| DRIVER'S
LICENSE: |
|
|
SIGNING
OFFICER |
| TELEPHONE
(incl. area code): |
|
|
| CONTACTS |
|
| FINANCE/ADMINISTRATION: |
|
| ACCOUNTS
PAYABLE: |
|
| PURCHASING: |
|
| PROJECT/JOB
MANAGER: |
|
|
| RENTAL
INSTRUCTIONS |
|
| |
|
| OBTAIN WRITTEN
PO ONLY: |
SHOW JOB SITE
ON INVOICE: |
| PHONE FOR
AUTHORIZATION OR PO: |
|
| RENT ONLY TO: |
|
| OTHER
INSTRUCTIONS: |
|
|
| BANK
REFERENCE |
| NAME: |
|
| ADDRESS: |
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| TELEPHONE
(incl. area code) |
|
| ACCOUNT # |
|
| |
|
LIST
THREE REFERENCES YOU HAVE
ESTABLISHED CREDIT WITH
This reference section must be completed in order to
process your application without delay. |
| |
|
| NAME: |
|
| ADDRESS: |
|
| TELEPHONE
(inc. area code): |
|
| FAX NO. (incl.
area code): |
|
| |
|
| NAME: |
|
| ADDRESS: |
|
| TELEPHONE
(inc. area code): |
|
| FAX NO. (incl.
area code): |
|
| |
|
| NAME: |
|
| ADDRESS: |
|
| TELEPHONE
(inc. area code): |
|
| FAX NO. (incl.
area code): |
|
|
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I hereby represent that I
am authorized to submit the credit application on behalf
of the customer named above. I / We hereby authorize The Rental Zone Inc.
to investigate references listed pertaining to my/our
credit and financial responsibility.
X________________________________________
Date: ____________
I
hereby certify all
information provided to be true and complete; authorize and consent
to the provision of account and credit information
from/to credit grantors, credit bureaus, and
suppliers of service; acknowledge and agree
to abide by the terms and conditions set out below.
X________________________________________
Date: ____________
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