Lease Application | Credit Card Authorization Form


LEASE APPLICATION

Applicant Information:

{{billing_first_name}} {{billing_last_name}}
 {{billing_phone}}
 

{{billing_address_1}} {{billing_address_2}}
{{billing_city}} {{billing_state}}, {{billing_postcode}}

Delivery Information:

Note: We do not deliver on weekends or holidays:
{{shipping_address_1}} {{shipping_address_2}}
{{shipping_city}} {{shipping_state}} {{shipping_postcode}}

Landlord/Mortgage Co.   Phone:

Monthly payment of residence:  

Mailing Address for Deposit Refund:


{{customer_wp_user_email}}

Employment Information:

Applicant's Employer's Name:  
Occupation:   Monthly Income:  
Length of Employment:  

Address: 


Supervisors Name:   Phone: Phone:  

References (Please Provide All 3 References):


 

 
 

  
 

CREDIT CARD AUTHORIZATION FORM

Cardholder Full Name:  

{{billing_address_1}} {{billing_address_2}}
{{billing_city}} {{billing_state}}, {{billing_postcode}}

Credit Card Number:  Please do not complete the last four digits example: 4242 4242 4242

The last 4 digits will be collected over the phone by one of our customer support specialists to complete your lease application. We take this extra step in order to build a personal relationship with all of our clients, and to protect your cardholder information.


Expiration Date:  

If you would like a receipt of the charge(s) made to this card e-mailed to you, please provide your e-mail address:  

I understand that the information I provided on this New Image Furniture Leasing application form will be used to verify and assess the application. Those companies or individuals may be contacted to confirm application details and to provide verbal or written details for verification purposes. Should any of the above given information on residency or employment change, I authorize New Image Furniture Leasing to verify with whichever applies, the new landlord, or employer. This is a permanent authorization for the duration of my active account with New Image Furniture Leasing.

To provide the best experience to our customers, we run a soft credit check that does not affect your credit score.

I agree and understand that by electronically signing I am providing “written instructions” to New Image Leasing (“New Image Leasing”) under the Fair Credit Reporting Act authorizing New Image Leasing to obtain information from my personal credit profile or other information from Experian. I authorize New Image Leasing to obtain information solely to prequalify me for credit options.

Additional Information on Soft Checks

Soft inquiries (also known as “soft pulls”) typically occur when a person or company checks your credit as part of a verification process. This may occur, for example, when a credit card issuer checks your credit to see if you qualify for certain credit card offers. Your employer might also run a soft inquiry before hiring you. We use a VantageScore (versus a FICO score) to consider those without a long credit history.


I authorize New Image Furniture Leasing to charge this card for all monetary obligations related to the lease agreement/s I have entered into with New Image Leasing, Inc.

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: Lease Application | Credit Card Authorization Form
lock iconUnique Document ID: 827b760ab6495b117b49264b0b50a05492580cef
TimestampAudit
November 22, 2019 4:21 pm MSTLease Application | Credit Card Authorization Form Uploaded by Chuck Green - chuck@newimageleasing.com IP 73.78.255.115
December 10, 2019 9:08 am MSTLyndsey Finamore - lyndsey@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 10, 2019 9:08 am MSTDionna Kaska - dionna@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 10, 2019 9:08 am MSTTom Ziegelbauer - tom@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 10, 2019 9:57 am MSTLyndsey Finamore - lyndsey@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 10, 2019 9:57 am MSTDionna Kaska - dionna@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 10, 2019 9:57 am MSTTom Ziegelbauer - tom@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 11, 2019 11:24 am MSTLyndsey Finamore - lyndsey@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 11, 2019 11:24 am MSTDionna Kaska - dionna@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 11, 2019 11:24 am MSTTom Ziegelbauer - tom@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 11, 2019 2:02 pm MSTLyndsey Finamore - lyndsey@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 11, 2019 2:02 pm MSTDionna Kaska - dionna@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 11, 2019 2:02 pm MSTTom Ziegelbauer - tom@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 12, 2019 9:09 am MSTLyndsey Finamore - lyndsey@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 12, 2019 9:09 am MSTDionna Kaska - dionna@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 12, 2019 9:09 am MSTTom Ziegelbauer - tom@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 23, 2019 9:39 am MSTLyndsey Finamore - lyndsey@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 23, 2019 9:39 am MSTDionna Kaska - dionna@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
December 23, 2019 9:39 am MSTTom Ziegelbauer - tom@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
January 3, 2020 2:21 pm MSTLyndsey Finamore - lyndsey@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
January 3, 2020 2:21 pm MSTDionna Kaska - dionna@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
January 3, 2020 2:21 pm MSTTom Ziegelbauer - tom@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
January 27, 2020 10:23 am MSTLyndsey Finamore - lyndsey@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
January 27, 2020 10:23 am MSTDionna Kaska - dionna@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115
January 27, 2020 10:23 am MSTTom Ziegelbauer - tom@newimageleasing.com added by Chuck Green - chuck@newimageleasing.com as a CC'd Recipient Ip: 73.78.255.115