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Business Lease Application

* Indicates required information. For questions or concerns about this form please read our Privacy Policy.

For additional guarantors, please complete a second application.

Business Information
Business Name *
Street Address *
City *
State *
Zip *
Business Phone *
Business Fax *
Type of Business *
Years in Business *
Officer Signing for Company *
Title *



Business Banking
Name of Bank *
Branch Location *
Account Number *
Officer *
Phone Number *



Driver Information
Driver First Name*
Driver Last Name*
Street Address *
City *
State *
Zip *
Home Phone *
Fax
E-mail Address *
Confirm E-mail Address *
Date of Birth * (mm/dd/yyyy)
Social Security Number *
Citizenship *
Own or Rent? *
How Long in Residence? * years
Previous Address
(if less than 2 years)
City
State
Zip
Position with Company *
How Long Employed? * years
Verifiable Annual Income *



Vehicle
  Please Enter the Description of the Vehicle you are interested in leasing:
Year *
Make *
Model *
Body Style
Color
New or Used
Mileage
Selling Price *
Down Payment
Finance Amount
Term of Lease
 
The above information is correct to the best of my knowledge. Premier Financial Services,
LLC (PFS) will rely on this application in deciding whether to grant the requested credit and
may keep this application on file. I authorize PFS, and its affiliates, to review my credit and
employment history, and, if approved, obtain future credit reports as necessary. PFS will
safeguard my information and will use it for internal purposes only. I understand that federal
law requires financial institutions to obtain, verify, and record identifying information.
  Indicate that you understand and agree with the above statement by typing your name below:
I understand and agree: *
Comments:
How to Submit Submit Form to Premier Financial Services
Create a Printable Version For Faxing (203-267-7773)
 
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