AUTRELLA LUX Leasing Application

Registered under corporation?
If you intend to register the vehicle under a corporation, please complete this additional section below. If not, please skip to section 2.
Firm Name
Nature of Business
Years in Business
EIN Number
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Vehicle Information
SECTION 3: VEHICLE INFORMATION [IF KNOWN]
Model Year
Make
Model and/or VIN
Estimated Annual Mileage
Selling Price (Or Estimate)
Desired Cash Down Payment
Any Trade Equity? (If So, How Much?)
I CERTIFY TO THE TRUTH OF MY STATEMENTS ABOVE and authorize the Dealer and any person whom this application is delivered to obtain credit reports on me. in connection with the Application and any Account established hereby. as well as any update. renewal, extension, review or collection thereof. If it does, will, upon request, be informed of that fact and each credit bureau's name and address. I also authorize the Dealer and any person whom this application is delivered to verify with others any information contained in this Application and to report its transactions with me.
SIGNATURE OF APPLICANT

Clear
DATE

MonthDayYear
Date
Should be Empty:

SECTION 1: INDIVIDUAL OR GUARANTOR