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| Your Business
Information |
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*Email: |
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Business
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Address: |
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City: |
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State: |
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Zip Code: |
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Phone: |
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Fax: |
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Type of
business: |
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Company
Type: |
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Company Established: |
mm/yy |
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| Principal(s) or
Officer(s) |
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Name: |
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Title: |
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Social Security Number: |
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Date of Birth |
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Home Address: |
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City: |
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State: |
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Zip Code: |
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| Bank References
(exact branch) |
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| Business |
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Bank Name: |
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Checking Account Number: |
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Type of Account:
Checking, Savings, Loan, etc. |
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Office of Contact Name: |
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Contact phone #: |
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Officer to Contact
Phone: |
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| Trade Reference
or Term Debt (1) |
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Company Name: |
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Account Number: |
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Phone Number: |
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Contact: |
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| Trade Reference
or Term Debt (2) |
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Company Name: |
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Account Number: |
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Phone Number: |
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Contact: |
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| Trade Reference
or Term Debt (3) |
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Company Name: |
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Account Number: |
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Phone Number: |
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Contact: |
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| Credit Release
Authorization |
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TO
WHOM IT MAY CONCERN: This document should serve as notice
to you that I/we are considering an industrial commercial
grade pre-engineered steel building. This document will
serve as your authorization to release any/or all credit
information regarding our accounts and any/or all corporate
financial statements providing credit accommodations
for the acquisition of this equipment. Your cooperation
in promptly responding to any such inquiries would be
greatly appreciated. |
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Legal
name of company: |
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Street
Address: |
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City: |
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State: |
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Zip |
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Phone
Number: |
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Fax Number: |
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Your Name: |
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Title: |
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Your
Signature |
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Please check here
if we can use this as your signature. |
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By clicking the
send lease application, I hereby authorize C.J. Martin Construction,
Inc., Inc., and any of it financial associates or funding
sources from time to time and during any relationship
with C.J. Martin Construction, Inc., to check reporting
information on Applicant and Principals named above and
relate this information to others as necessary. I also
hereby authorize any references to release information
as may be requested by C.J. Martin Construction, Inc., Inc.
I further authorize any photostat copies of this release.
I certify this application is true and correct.
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