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* Are Required fields   Today's Date:

This is an application for credit. Completion and submission of this form acts as authorization for American Rent-All to investigate any and all information contained herein. Submission of this form also acts as agreement to our payment terms and conditions.

*Company or Organization Name:           FIN:
*Last Name:              *First Name:             Middle Initial:
*Street Address:         Unit/Suite     
*City:                         *State:               *Zip:
*Phone:                  *E-Mail          Years at address:
*This is a : Corporation LLC Partnership Sole Proprieter Individual
     
     
Principals

Give the names of all owners, principal stockholders, shareholders or officers.

Position/Title:
First Name:
Last Name: Phone:
Complete Address:    Zip Code:
   
Position/Title:
First Name:
Last Name: Phone:
Complete Address:    Zip Code:
   
Position/Title:
First Name:
Last Name: Phone:
Complete Address:    Zip Code:
Position/Title:
First Name:
Last Name: Phone:
Complete Address:    Zip Code:
 
Bank Information
Bank Name :   Complete Address:   Zip Code:
Bank Officer/Contact Person: Phone:  
 
Credit References
Company Name:   Complete Address:   Zip Code:
Contact Person:    Phone:
 
Company Name:   Complete Address:   Zip Code:
Contact Person:    Phone:
 
Company Name:   Complete Address:   Zip Code:
Contact Person:    Phone:
 
Company Name:   Complete Address:   Zip Code:
Contact Person:    Phone:  
 
   
Applicant's Statement
Checking the following boxes will act as your electronic signature to this credit application. Please be sure to read and understand the statements before sending the application.
Cash sales are OK until credit is approved.
I/We hereby authorize American Rent-All to check with my/our credit references and banking institutions as listed on this application.
I/We understand this information will be used to determine credit worthiness according to American Rent-All's standards.
I/We release all parties from any liability in connection with the provision and use of such information.
I/We fully understand and agree that, if granted credit, I/we will abide by American Rent-All's payment terms and conditions, which I/we understand are subject to change.
I/We certify that all the information contained in this credit application is correct and true.
Name of person completing application: Title:
 

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