Secure Lease Application

Your application is transmitted securely and is carefully reviewed and processed by an experienced officer at Avalon Leasing. Please complete all required fields at a minimum and feel free to email us or call (888) 332-8007 for assistance. We may need to contact you for clarification on certain items so please include your best telephone number.

    Contact Information

    Company information

    assisted livingindependent livingmemory careCCRCnursing facility

    Equipment Supplier

    Bank Information If Over $50,000

    Ownership/Officers: List all 20%+ Owners

    Equipment and Terms

    Comments

    AUTHORIZATION

    Submitting this application electronically shall have the same force and effect as if the application bore inked signatures. The information submitted is for the purpose of obtaining credit and is deemed to be true and correct. The individual(s) who submit personal credit information understand that the evaluation of their individual credit history may be a factor in the final credit decision process and authorization Avalon Leasing, Inc. and/or their affiliates to obtain a consumer credit report for this purpose and shall hold Avalon and their affiliates or assignees harmless from same. Authorization to review company, personal and banking history is permitted with the election acceptance below.

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