Financing Applicant InformationFirst and Last Name*Email* Mobile Phone Number*Address*State*City*Zip Code*Sales RepresentativeJohn MacbethIdentification Purpose of Collection: Identity Verification: This information helps us confirm your identity and reduce the risk of fraud during the financing process. Credit Check: It may be used to assess your creditworthiness, which influences the terms of your financing agreement. Data Protection Assurance: Confidentiality: Your information will be kept confidential and will only be accessed by authorized personnel involved in the financing process. Secure Storage: All data will be stored securely in compliance with relevant privacy laws and regulations. Limited Use: We will not share your information with third parties without your consent, except as required by law. Privacy Commitment: We value your privacy and are committed to protecting your personal information. If you have any questions about how your data will be used or stored, please feel free to ask. Select Your Identification Method*Utility Bill or Bank StatementDriver's License NumberEmployee ID NumberChoose one of the options aboveEnter Driver's License Number*Enter Employee ID Number*File UploadClick on choose file to upload utility billEmployment & Income InformationEmployer*Job Title*Anual Income*Monthly Income*Credit ScoreCommentsTerms and ConditionsI agree that I am able to afford the down paymentYesNoselect your answer Payment Term: The monthly payment of must be received by the 4th business day of each month to avoid late fees. Late Payment: A late fee will be applied if payment is not received by the due date. Grace Period: The client has a 10 days grace period to complete the payment before the late payment fee will be applied. Collection Actions: Continued failed payments will result in collection actions Fee for Late Payment: $13 for any payment received after the due date. Prepayment: Customers may choose to pay off the financing amount early without any penalties or interest charges. Notification: Customers must provide written notice of intent to prepay 5 days in advance. Balance Adjustment: Any prepayment will reduce the total balance owed without incurring additional interest. Authorization and ConsentI authorize Containerx-press to perform a credit check*YesNochoose a responseI consent to receive electronic communications from Containerx-press*YesNochoose a responseI have verified that the information I have provided is accurate*YesNoSignatureEnter your name, to be used as an electronic signature This iframe contains the logic required to handle AJAX powered Gravity Forms.