Apply for Lease

Complete the rental application below…

BRIDGES & BOROUGHS FURNITURE

RENTAL APPLICATION & AUTHORIZATION TO CHARGE CARD

Name (required)

Email (required)

Driver's License

Social Security Number

Telephone Number

Mobile Telephone Number

Date of Birth

Permanent Address

City

ZipCode

State

Length of Apartment Lease

Rental Agent or Landlord

Apartment Rent $

Employer

Business Address

Length of Employment

Occupation

Monthly Income

Supervisor's Name

Name of closest relative not residing with you

Relationship

HOW DID YOU FIND BRIDGES & BOROUGHS?

Name of Agent

Which package would you like to lease?


Delivery Location

Delivery Address

Apartment #

City

ZipCode

State


Credit Card Required

Name as it appears on card:

Type of Card

Expiration Date

Account Number

Authorization Number

AUTHORIZATION TO CHARGE MY CREDIT CARD

I hereby authorize Bridges & Boroughs Furniture (“B&B”) to charge my credit card indicated above for current and future charges incurred for furniture rented by me. This authorization shall remain in full force and effect for so long as I am renting furniture and for any unpaid charges incurred throughout my rental term. A copy of this Authorization to Charge My Credit Card shall be considered as valid as the original.

APPLICANT CERTIFICATION / AUTHORIZATION

The information on this Rental/Credit Application is provided to Bridges & Boroughs Furniture (“B&B”) for the purpose of securing a Furniture Lease Agreement. By submitting the above information, I hereby acknowledge that I understand and agree to the following:

  • I hereby verify that this information is true, correct, and complete.
  • I understand and agree that my lease agreement with B&B will not become effective until this Credit Application has been approved.
  • B&B is authorized to check my credit with: (a) any credit reporting company/agency; (b) any commercial bank and/or financial institution; (c) with any landlord; (d) with any other persons or business entity as B&B may, at its sole discretion, deem necessary.
  • B&B is authorized to confirm my current employment and to make inquires regarding my termination of employment with any prior employer.
  • B&B may do anything authorized in Applicant’s Certification for as long as I am renting/leasing furniture from B&B.

I agree with all the Terms and Conditions.