RCI Wireless GPS Starter Interrupt Tracking

RCI Wireless Control Inc leasing program is made available through Lease Corporation of America (LCA) where LCA is a small ticket lessor that primarily focuses on the dealers, distributors and manufacturers of point of sale equipment, auxiliary power units, telecommunication, wireless, and security equipment. In addition, LCA services vendors of furniture, copiers, computers, and automotive repair equipment. Since its founding in 1988, LCA has had working relationships with over 2,247 vendors of all sizes from across the United States and Canada. Over the years, LCA has booked and serviced over 57,000 leases, with an equipment cost value in excess of $525 million. LCA has lessees in all 50 states.

1. EQUIPMENT

Number of Modules :

Model :

Proposed Terms :

2. APPLICANT COMPANY INFORMATION

Company Name :

Years in Business :

D/B/A :

Signer Name & Title :

Company Address :

Company City :

Company County :

Company State :

Company Zip :

E-Mail Address :

3. PERSONAL INFORMATION OF GUARANTORS

Guarantor 1 :

Guarantor 2 :

Title :

Social Security no :

Drivers License no :

Home Address :

Home City :

Home State :

Home Zip :

Home Phone no :

(555-555-1212)

Home Phone no :

(555-555-1212)

Own or Rent :

How Long :

Annual Income :

Date of Birth :

(YY-MM-DD)

Date of Birth :

(YY-MM-DD)

4. COMPANY BANK REFERENCES - TWO (2) YEAR HISTORY

Name of Bank :

How Long :

Check Account no :

Telephone no :

(555-555-1212)

Telephone no :

(555-555-1212)

Contact Officer :

5. TRADE REFERENCES - TWO (2) YEAR HISTORY

Name of Supplier :

City :

State :

Telephone no :

(555-555-1212)

Telephone no :

(555-555-1212)

Contact Officer :

6. APPLICANTS FINANCIAL INFORMATION

No. of years in this line of business :

No. of years in this business at current address :

No. of employees :

Approximate net worth of business :

Approximate net profit after tax last year :

Approximate net profit after tax for the year before last :

Acknowledgements & Authorizations
By clicking on the submit button below, you, the credit applicant, certify that the information given for credit purposes is true and correct; authorizes Lease Corporation of America, its assigns, and any credit bureau or other investigative agency to investigate the references, statements and other information accompanying this application; and, expressly authorizes bank and trade references listed herein to release credit and information requested as part of said investigation.
	
ECOA Notice
If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact Credit Disclosure Administrator, Lease Corporation of America, 3150 Livernois Road, Suite 300, Troy, MI, 48083, within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this credit is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580.

I accept the above mentioned terms

Should you require assistance filling out this form, please contact RCI Wireless Control customer support, by dialing: 1-877-940-3028,
during normal business hours, 9:00AM to 5:00PM EST, Monday to Friday. or send us an email to: support@rciwirelesscontrol.com

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