Co­Signer Application

[Pages:1]CoSigner Application

Please fill in the spaces below and email or fax us the application AND your Proof of Income

We will need ONE of the following:

Current W-2 / 1099 Current Paystub Current Awards Le er

QuickSpark App # ______________ (given to you at the time of application submission)

Legal Business Name:

DBA:

Business Address:

Business Phone:

Email:

Business En ty:

Corp

Name: Rela onship to Owner: Owner's Name: Date of Birth: Address: City: Home Phone: Email:

State: SSN:

Business Informa on

City:

Website:

Tax ID (TIN) #:

LLC

LLP

Partnership

Signer Informa on

Name:

Rela onship to Owner:

Owner's Name:

Date of Birth:

Address:

Zip:

City:

Home Phone:

Email:

State:

Zip:

Time in Business:

Sole Prop

Other

State:

Zip:

SSN:

Terms and Condi ons Statement

The above informa on, together with any accompanying financial statements, schedules, or other materials, is submi ed for the purpose of credit pre qualifica on and is warranted to be true, correct, and complete. If applying for Business credit, you acknowledge and affirm that one or more applicants iden fied above is/are the business owner(s) and is/are personally liable for the business. You also warrant that by submi ng this Applica on for Financing, any individual iden fied above who is either a principal, a personal guarantor, co signer or a sole proprietor of the credit applicant, recognizing that his or her individual credit history may be a factor in the evalua on of the applica on for financing, is authorizing inquiry into their creditworthiness, including but not limited to obtaining a consumer credit report, and shall hold LeaseSta on Holdings LLC, its assignees, agents, or nominees harmless from same. You understand that such inves ga on may include seeking informa on as to the background, credit, and financial responsibility of your officers and principals (or any of them) if applicable. The Federal Equal Credit Opportunity Act prohibits creditors from discrimina ng against credit applicants on the basis of race, color, religion, na onal origin, sex, marital status, or age (provided the applicant has the capacity to enter into the binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protec on Act. If for any reason your applica on for credit is denied, you have the right to a wri en statement of the specific reasons for the denial. To obtain the statement, please write to LeaseSta on Holdings LLC within 60 days from the date you are no fied of our decision. We will send you a wri en statement of reasons for the denial of credit within 30 days of receiving your request for the statement.

CO-Signer Signature: __________________________________________________ 2nd Signer Signature: __________________________________________________

Date: _____________________________ Date: _____________________________

1305 W. Auto Drive, Tempe, AZ 85284 | P: 800-770-8107

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