Type of Business (check one) Corporation Proprietorship Partnership
In which city/area will you need furniture?
______________________________________
Name of CORT Putnam sales person (if you are working with one)
______________________________________
How long have you been in business?
______________________________________
INSTRUCTIONS (Please print or type all information)
Corporation:
Complete Section 1 (If incorporated for two (2) years or less, a personal guarantee by a Corporate Officer is required.
Guarantor must complete Section 2).
Proprietorship:
Complete Section 1 and Section 2
Partnership:
Complete Section 1 and Section 2
SECTION I
Name of Business DBA (if different)
Phone Number Fax Number
Email
Prior Company Name (if changed within 1 year)
Local Address: Street City State:
Zip:
Principal Address: Street
City State:
Zip:
Nature of Business
If Incorporated Where
Corporate Officers: President
V.P
If Partnership, Principal Partner (1)
Partner (2)
Bank Name
Branch Location
Phone #
Account #
Landlord Phone # Contact
The information on this application is submitted for the purpose of securing a Rental Agreement for CORT Putnam Furniture Rental (CORT). I hereby certify that
falsification of this data is grounds for CORT refusing to enter into Rental Agreement. I acknowledge and agree that my Rental Agreement with CORT will not
become effectiv