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TANNING
Level 1
Level 2
Level 3
Level 4
Level 5
Spray Tanning
SPA
IPL
Microdermabrasion
LED
Rejuvenessence
MEDICAL
Cosmetic Lasers
Ultrasound
X-Ray
Body Scan
LAMPS
View All
SSL Certificates
Credit Application
Andrew Wilson
National Account Manager
Phone: 866-484-5575 x202 Fax: 866-689-3555
LESSEE (exact legal name required)
*
Required Field
Name:
*
*
Address:
*
*
City/State/Zip:
*
*
Telephone Number:
*
*
Fax Number:
*
*
Contact Person:
*
*
Title:
*
*
E-Mail Address:
*
*
Invalid
EQUIPMENT DESCRIPTION:
New
Used
Total Equipment Cost
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*
Equipment Location
(if other than above)
Type of Business:
Corporation
Partnership
Proprietorship
Non-Profit
Government
Other
Lease Term
Purchase Option
FMV
10%
$1.00
Security Deposit(s)
0
1
2
Advance Payment(s)
0
1
2
Monthly Payment $
Plus Tax $
Total Payment $
Banks
Bank Name 1
Type of Account
Account Number
Contact Officer
Telephone Number
Bank Name 2
Type of Account
Account Number
Contact Officer
Telephone Number
TRADES
Name 1
Telephone Number
Name 2
Telephone Number
Name 3
Telephone Number
Name 4
Telephone Number
Please provide the following on principals and/or owners:
Name
Home Address
City/State/Zip
Social Security Number
Name 2
Home Address
City/State/Zip
Social Security Number
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