Financing Option

Financing from 54 to 144 months available

💰 We have financing from 54 to 144 months available

SALE DETAILS

For salesperson use — fill in product and price

Salesperson Name

Product

Price ($)

PRIMARY APPLICANT

Full Name *

Date of Birth

S.S.# (XXX-XX-XXXX)

📷 License - FrontFront photo

📷 License - BackBack photo

Address

Time at Residence

Phone *

Email *

Employment Info

Employer Name

Work Address

Work Phone

Position

Monthly Income ($)

Additional Income ($)

Mortgage / Rent

Mortgage/Rent Payment ($)

Al firmar este documento de forma voluntaria autorizo expresamente a Planet Water System LLC que obtenga y verifique su información crediticia a través de las agencias de crédito pertinentes, con el fin de evaluar su solicitud de crédito actual.

By voluntarily signing this document, I expressly authorize Planet Water System LLC to obtain and verify my credit information through relevant credit bureaus for the purpose of evaluating my current credit application.

AUTHORIZATION FORM FOR AUTOMATIC PAYMENTS (ACH)

I hereby authorize AQUA FINANCE, INC. (AFI) to initiate automatic payments (ACH) from my bank account as indicated below. I understand that this authorization will remain in effect until I notify AFI in writing to cancel.

Date

Automatic Payments Start Date

Amount ($)

Bank Name

Bank Address

Routing Number

Account Number

I confirm that I authorize automatic ACH payments from my bank account as per the details provided above.

Client Name (Applicant)

Co-Applicant Name (if applicable)