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FORTIVA and YBUY - LEASING PROGRAM
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* Indicates required question
STORE LOCATION:
*
Choose
117 - STATE COLLEGE
118 - FULLERTON
119 - LONG BEACH
120 - EUCLID
121 - ORANGE
127 - SANTA ANA
128 - WILMINGTON
130 - KATELLA
YOUR NAME
*
Your answer
APPLICATION NUMBER
*
Your answer
LEASE AMOUNT OF THE DEVICE
*
only the device amount before taxes not the total amount approved
Your answer
PRINT OUT (E SIGNATURE FORM)
*
MUST COMPLY WITH ALL THREE
COPY SUBMIT THROUGH EMAIL (
mko.lexcell@gmail.com
)
ONE COPY FOR THE STORE RECORD
ONE COPY FOR THE CUSTOMER
Required
RQ TRANSACTION (INVOICE NUMBER)
*
Your answer
CUSTOMER NAME
*
Your answer
CUSTOMER PHONE NUMBER
*
Your answer
CUSTOMER PIN NUMBER
*
Your answer
LEASING DEVICE MODEL
*
Your answer
LEASING DEVICE IMEI NUMBER
*
Your answer
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