Business Name
Tax ID Number: 123456789 (No Hyphens)
Business Address
City
State / Province
Postal / Zip Code
Business Type
Business Type
Sole
Proprietorship
Limited Liability Company
Cooperative
Corporation
Partnership
S Corporation
Incorporation
Proprietorship
E-Mail Address
Business Phone
Gross Annual Income
Year Established
Bank Name
Bank Phone
Branch Address
City
State / Province
Postal / Zip Code
Contact Person
Account Number
These are optional fields, made available should you want to upload any supporting documentation. Examples could be a credit report, copy of photo id, etc…
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By typing your name below. You agree to the following terms and to our terms of service. I hereby authorize the property owners, it’s employees, agents, and third parties (jerseyautolease) to take any and all actions necessary to verify the contents of this application. I understand that such actions may include but are not limited to, a credit report, verification of employment, past rental history, police and criminal records, I will hold the property owner, it’s employees, agents and third parties harmless from liability for the accurate reporting of such information to the management and/or owners. I also consent to allowing the property owner/manager/agents to use any information provided here to assist in debt collection activities if required. I certify that all information provided by me is true, correct, and complete and I understand that any misrepresentation or omission is caused for the management and/or owners to reject or decline this application and/or terminate any lease based on this application. I hereby authorize jerseyautolease.com and/or their directors, officers, employees, volunteers, representatives, vendors, and agents to pick up and deliver agreed upon vehicle to/from dealership to/from agreed upon location of delivery and assume all of the risk of having my vehicle delivered to the destination I selected. In consideration of the additional delivery fee that the company waived, in exchange for this release, and service provided, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: I waive, release, and discharge from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released and indemnify, hold harmless, and promise not to sue jerseyautolease.com and/or their directors, officers, employees, volunteers, representatives, vendors, and agents, for any and all claims that relate to or arise out of delivering my vehicle from its current location to the destination of my choosing. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I certify that I have read this document and I fully understand its content. I am aware that this is a release of liability and a contract and I sign it out of my own free will.
Applicant Electronic Signature
Current Date/Time
