nfr_form

If you would like to finish this over the phone, please feel free to call Great Lakes Rent to Own at +1 989 773 0524

CONTACT INFORMATION

Email*

Confirm Email*

Customer Name: First*

Middle

Last*

Mobile Phone*

Secondary Number

Describe what you are looking for.

Marital Status*

Spouse Full Name*

Spouse Email*

RENTAL CUSTOMER

Social Security Number

Birth Date

Driver's License Number.

LOCATION

Mailing Address

City

State

Zip

Property will be located at a DIFFERENT address.

Physical Address (where property will be located)

City

State

Zip

Residence: Rent Own

Landlord's Name

Landlord's Phone

ALTERNATE CONTACT

In the event we cannot reach you, please provide an alternate contact outside of the home.

Name

Phone

Relationship

ALTERNATE CONTACT 2

In the event we cannot reach you, please provide an alternate contact outside of the home.

Name

Phone

Relationship

EMPLOYMENT & BANKING

Employment Status: Employed Self-Employed Retired/Disability

Employer

Work Phone

Supervisor Name

Length of Employment

Company Name

Work Phone

AutoPay: Yes No

Monthly Income

Liability Waiver Program (LWP): Yes No

Comments

CO RENTAL CUSTOMER

Co-Name: Spouse Other None

First

Middle

Last

Social Security Number

Birth Date

License No.

Mobile Phone

Email*

Employment Status: Employed Self-Employed Retired/Disability Other

Employer

Work Phone

Company Name

Work Phone

Explain:

By signing this document, customer grants Great Lakes Rent to Own or its affiliates or representatives or contractors the right to remove any and all obstructions upon retrieval of the asset including but not limited to fences, gates, locks, autos, boats, trailers or other items as deemed necessary by Great Lakes Rent to Own or its representatives. The customer releases Great Lakes Rent to Own or its representatives from any and all liability or damages relating to the removal or damage to obstructions. Does customer agree?

CONTACT INFORMATION

RENTAL CUSTOMER

LOCATION

ALTERNATE CONTACT

ALTERNATE CONTACT 2

EMPLOYMENT & BANKING

CO RENTAL CUSTOMER

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