PutnamLeasing || Individual Lease

* Indicates required information. For additional guarantors, please complete a second application.

Auction/Event:
	Applicant Information
First Name*:
Last Name*:
Street Address*:
City*:
State*:
ZIP*:
Home Phone*:
Fax:
Email Address*:
Confirm Email Address*:
Date of Birth*:
Social Security Number*:
Citizenship*:
Own or Rent*:
How Long*:
Mortgage Holder or Landlord*:
Monthly Mortgage/Rent Payment*:
Personal Bank*:
Previous Address: (if less than 2 years)
City:
State:
ZIP:

	Employment Information
Employer*:
Street Address*:
City*:
State*:
ZIP*:
Employer Phone*:
Employer Fax:
Years Employed*:
Position*:
Verifiable Annual Income*:
Additional Income:
Source:
Previous Employer:
Street Address:
City:
State:
ZIP:
Phone:

	Vehicle Information
	Please enter the description of the vehicle you are interested in leasing:
Year*:
Make*:
Model*:
Body Style:
Color:
New or Used:
Mileage:
Selling Price*:
Down Payment:
Lease Cap Cost:
Term of Lease:

The above information is correct to the best of my knowledge. Putnam Leasing, will rely on this application in deciding whether to grant the requested credit and may keep this application on file. I authorize Putnam Leasing, and its affiliates, to review my credit and employment history, and, if approved, obtain future credit reports as necessary. Putnam Leasing will safeguard my information and will use it for internal purposes only. I understand that federal law requires financial institutions to obtain, verify, and record identifying information.

Indicate that you understand and agree with the above statement by typing your name below:

I understand and agree*:
Comments:
Sales Rep:
How to Submit:	Submit Form to Putnam Leasing Create a Printable Version For Faxing

To prove you are a human completing this form answer the following question*: 6 plus 2 equals