Bendele Technology Credit Application Form

Bendele Technology Credit Application Form

Please fill out this form to apply for credit. All information provided will be kept confidential. Your job is your credit.
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Item Description
Residential Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Social Security Number
Employment Status
Monthly Income (in USD)
Please provide any additional information relevant to your credit application
Employer Name
Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Length of Employment (Years)
Reference 1 (Family Member)
Reference 1 Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2
Reference 2 Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3
Reference 3 Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 3 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
I agree to the terms and conditions of this credit application. The decision to grant payments on Bendele Technology items is at the sole discretion of Bendele Technology and not through any bank. If approved applicants must provide First month and Last month payment to start lease. Payment terms are 6 month, 12 month, or 18 month depending on the value of the item being leased. If for any reason you are unable to make your regular payments you agree to contact Bendele Technology and return the item with no penalty. At time of return if your device has personal data on it Bendele Technology will assist with putting your data onto a thumb drive so that none of your personal data is lost. Tech support is provided while in an active lease. At the end of the lease if all payments have been made the device is yours to keep.
Should be Empty: