Customer Application Form
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1
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3Secured Yard Location:
Billing:
P.O. Box 200383
9701 E. 102ND AVENUE
Evans, CO 80620
HENDERSON, CO 80640
(303) 219-4396
(303) 219-4396
FAX (360) 935-8573
CUSTOMER APPLICATION FORM
Please complete all credit information in detail. A complete form provides information that will help us better respond to your equipment needs.
If you have a question about how to complete this online application form, please contact our Customer Service Center at 1-970-518-9079. Thank you.
Copies of your most recent year-end financial statements are required for all lease arrangements of 12 months or longer and for self-insurance requests.
Financial statements are held in strictest confidence and will be forwarded to an All Ways Leasing, LLC regional credit manager for review.
If your lease/rental transactions are tax exempt, you must return a completed tax exemption certificate for each state in which your company wants to establish
an account.
Thank you for your interest in doing business with All Ways Leasing, LLC. We look forward to serving you.
CUSTOMER INFORMATION:
Company Legal Name ______________________________________________
Street Address: _________________________________________________ City, State and Zip Code: ____________________________________________
BILLING ADDRESS if different from Street Address:
May we bill you via email? ______Yes
________No
Billing Address: ___________________________________________City, State and Zip Code: __________________________________________
Phone:______________________________________________________ Fax #: ___________________________________________________________
Email: ______________________________________________________ Web Site: ________________________________________________________
President/CEO: _______________________________________________ Officer (Name & Title): ____________________________________________
BUSINESS TYPE:
(Select the type that best describes your business)______Sole Proprietorship
_______Corporation
_______Partnership
Fed ID or Tax ID Number: ___________________________________
If a Sole Proprietorship, please fill out the following information:
First Name: ________________________________
Social Security Number:_____________________
Middle Name: ______________________________
Date Of Birth (MM/DD/YY): ________________
Last Name: ________________________________
The name shown under Sole Proprietorship must be the same individual who approved the Standard Terms and Conditions.
By selecting Sole Proprietorship, you authorize All Ways Leasing, LLC to conduct a personal credit check to verify the information on this
application.
GENERAL BUSINESS INFORMATION:
Date Operation Began (mm/dd/yyyy):_________________________________
Number of Employees: __________________
Type of Business: ____________________________________________________
Are purchase orders required to do business with your company? YES ___________
NO ____________
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