V 3.0.3.1
Dealer Support
+1 (770) 575-5980
+1 (770) 217-4116
applications@mplease.com
Add New Lease Application
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Change
1
Customer Information
2
Banking Information
3
Final Information
Dealer & Store
Customer Information
Co-Lessee
Primary Lessee Information
First Name
Last Name
SSN / TIN #
Date of Birth
(MM/DD/YYYY)
License #
License State
Street 1
Apt #
Zip Code
City
State
Mobile
Home Phone
Length of Residence
Year(s)
Month(s)
Rent
Own
Email
Salesperson (Optional)
Co-Lessee Information
First Name
Last Name
SSN / TIN #
Date of Birth
(MM/DD/YYYY)
License #
License State
Street 1
Address is same as Primary
Apt #
Zip Code
City
State
Mobile
Home Phone
Length of Residence
Year(s)
Month(s)
Rent
Own
Email
Declaration
BY CLICKING ACCEPT AND SUBMIT, I HEREBY:
Declare and affirm that the statements made herein are true, correct and complete. You may contact any person or company that I have listed and I fully release all parties from any and all liability for any damage it may result.
Understand and agree that a consumer report may be obtained in connection with my application.
Understand that Merchants Preferred Lease-Purchase Services will only charge an application fee/ initial payment (based on state requirement) to the card provided if a contract is prepared and generated.
Understand that this application is subject to approval by Merchants Preferred Lease-Purchase Services at its offices in the State of Georgia and that all payments are remitted to Georgia.
Understand this action counts as my electronic signature.
If any information has changed, current information must be updated. All information will be validated. Does any information need to be updated?
Yes
No, Continue