MFE New Customer Registration Form

Business Information
Corporate Officer Name

First NameLast Name
Title
Company Charter
Corporate Officer Phone Number
Please enter a valid phone number.
Email
example@example.com
Length of Time in Business
(including years and months)
Guarantor Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Proof of Residence

Cancelof
INE ID
Company Phone Number
Power of Attorney
Property Title of Guarantee
Official Document of Freedom From Encumbrance
Promissory Notes
Insurance
Insurance is the responsibility of the renter to make good to the owner all loss or damage to equipment.

Accordingly, the renter must have adequate insurance coverage in operation of equipment. If no COI (Certificate of Insurance) is provided an Equipment Damage Waiver will be charged to your invoice.
Insurance Company
Phone Number
Please enter a valid phone number.
Contact Person:

First NameLast Name
Policy Number
Policy Renewal Date

MonthDayYear
Date
Policy Type
Policy Coverage
Please attach your blanket COI, if applicable.

Cancelof

Business/ Trade References

Please complete this section only if you are requesting payment terms.
If you are requesting payment TERMS, please continue. There are no credit inquiries to credit bureaus on businesses. Credit Reference request only to your Business/ Trade Reference as listed. Please list Vendors with credit terms that supply goods or services to your business. No Customer information, please. You may use a business that you have loans with. Inquiries will never be invasive to your personal information. If you have any questions, please contact our Accounting Dept. If you are not requesting TERMS, please continue to the Agreement section.
REFERENCE 1 | Company Name:
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country
If this is a loan, please provide account number only:
REFERENCE 2 | Company Name:
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country
If this is a loan, please provide account number only:
REFERENCE 3 | Company Name:
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country
If this is a loan, please provide account number only:
Please attach any information you wish us to consider.

Cancelof
Name (of agent filling out form) *

First NameLast Name
Job Title (of agent filling out form)*
(of person submitting application)

Agreement
1. The undersigned (“purchaser/ lessees”) agrees that all purchases made by (“purchaser/lessee”) from MFE Enterprises/ MFE Rentals are subject to MFE Rentals terms and conditions.

2. In making this application for commercial credit, I/we agree to pay all invoices within 30 days (or agreed Terms is different, only by approval).

3. I/we authorize MFE Enterprises/ MFE Rentals to make inquiries into the business/trade reference supplied. Including credit inquires, as it deems necessary in connection with this application.

4. The undersigned confirms that it or any of its subsidiaries are not listed on any denied parties list and will notify MFE Enterprises. MFE Rentals if this should occur.
Name of Signatory *

First NameLast Name
Job Title of Signatory*
(of person submitting application)
Signature*

Clear
Signature of the Legal Representative

Clear
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Should be Empty:

New Customer Registration Form

Customer Information:

Accounts Payable Information

Business Information

Guarantor Information

Insurance

Business/ Trade References

Agreement