Life Fitness Credit Application

Keri Castoro

lease-application-data
9525 Bryn Mawr Avenue

Rosemont, IL 60018

Return by email or fax to: creditapplications@lifefitness.com or 847-288-3795

Toll Free 1-800-735-3867

Application for Open Trade Credit Terms

Brand Name (if any)

Corporate/Legal Entity Name

DBA

Ship To Location

Street Address

City, State, Zip

Main Phone #

(

)

Local Contact for Purchase

Contact Phone #

(

)

Owner Name(s) and % Owner Contact Phone(s)

Bill To Location

Street Address

City, State, Zip

Main Phone #

(

)

A/P Contact for Purchase

A/P Phone #

(

)

Same as Ship To Site listed

# years in business Life Fitness Sales Rep Name Quote #

Bank Reference I, the undersigned, by my signature below, hereby authorize Life Fitness to acquire credit information on the company listed above for the purpose of establishing open credit for fitness equipment purchases.

Bank Name Bank Branch City, State Name on the Account Checking Acct# (REQUIRED) Savings/Loan/Line of Credit Acct #

Contact Name Phone # Fax # Tax ID#

() ()

Bank Authorized Signature

Title

Date

Printed Name Email Address
Please attach two (2) months corporate bank statements that would be relevant to this request for terms.

Guarantee of Payment and Acceptance of Terms In consideration of your extended credit, the Terms & Conditions of Sale as set forth are hereby accepted. Standard terms are Net 30 days from invoice date (FOB Shipping Point). Interest will accrue at 1.5% per month on any past due balance, or maximum allowable by law.

Terms and Conditions of Sale can be found at https://www.lifefitness.com/terms-conditions-of-sale . Please read all terms and conditions. Provide any applicable tax exempt or resale forms upon return.

Business Information
FULL LEGAL NAME OF BUSINESS
FEIN #

Lease Application
STATE OF INCORPORATION

CORPORATION

PARTNERSHIP

LLC

OTHER

YEARS BUSINESS IN OPERATION

CORPORATE/BILLING STREET ADDRESS

CITY, STATE, ZIP CODE

EQUIPMENT LOCATION ADDRESS

CITY, STATE, ZIP CODE

BUSINESS PHONE NO.

(

)

BUSINESS REAL ESTATE

RENT

OWN

LANDLORD /MORTGAGE HOLDER

PHONE NO.

(

)

TYPE OF ACCOUNT

BUSINESS

PERSONAL

HOW LONG? CHECKING ACCT. NO. HIGH CREDIT AMOUNT HOW LONG?

BANK OFFICE SAVING ACCT. NO. CONTACT

Principal Information (Primary)
PRINCIPAL'S FULL NAME (Last Name, First, MI)

TITLE

OWNERSHIP %

PHONE NO.

(

)

LOAN NO.

PHONE NO.

(

)

SOCIAL SECURITY NO.

PRINCIPAL'S STREET ADDRESS

HOW LONG?

BIRTHDATE (Mo/Day/Yr)

CITY, STATE, ZIP CODE E-MAIL ADDRESS CURRENT EMPLOYER
Principal Information (Secondary)
PRINCIPAL'S FULL NAME (Last Name, First, MI)

TITLE

RENT

OWN

HOW LONG?

HOME PHONE NO.

(

)

CELL PHONE NO.

(

)

SALARY

U.S. CITIZEN

YES

NO

OWNERSHIP %

SOCIAL SECURITY NO.

PRINCIPAL'S STREET ADDRESS

HOW LONG?

BIRTHDATE (Mo/Day/Yr)

CITY, STATE, ZIP CODE E-MAIL ADDRESS CURRENT EMPLOYER

RENT

OWN

HOW LONG?

HOME PHONE NO.

(

)

CELL PHONE NO.

(

)

SALARY

U.S. CITIZEN

YES

NO

Authorization to Release Bank Information I/We hereby authorize Life Fitness, or its designee, to investigate my/our financial responsibility and credit worthiness. This is my/our authorization for the herein listed bank reference(s) to release any information requested by telephone as part of normal procedures.
I hereby represent all information is true, correct and complete. A photostatic copy of this authorization shall be valid as the original.

Authorized this

day of

, 20

Company Name

Authorized Signature

Title

Additional financial information may be required for lease requests over $75k and start up transactions. See next page for list of financial information.

EQUAL CREDIT OPPORTUNITY ACT. If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact Life Fitness, 9525 Bryn Mawr Ave, Rosemont, IL 60018 at (847) 288-3300 within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement. NOTICE: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income
derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580.
FCRA AUTHORIZATION TO CONDUCT CREDIT INQUIRY ON INDIVIDUAL OWNERS/SOLE PROPS: By submitting this application, the undersigned warrants that the applicant and each individual listed as principal, owner, partner, guarantor or obligor consent, authorize and warrant that Life Fitness and companies to whom it refers this application, may obtain commercial and consumer credit reports, investigate references and statements, and make other credit inquires about the applicant and all such individuals, and anybody contacted in connection therewith may
release any credit and financial information.

Life Fitness Leasing Basic Credit Review Requirements
1. Complete lease application 2. Last two years' Fiscal Year End Financial Statements* or Business Tax Returns, including
all schedules 3. Year-to-date Interim Financial Statements 4. Current, signed Personal Financial Statements for principal stockholders 5. Last two years' Federal Tax Returns, including all schedules, for principal stockholders 6. For start-ups, a Business Plan and Projections are required 7. For existing (current) lessees, only updated app and last two months bank statements
required
* Financial statements are composed of a balance sheet, income statement, accountant's statement and notes; cash flow statements are helpful but not required.
©2019 Life Fitness, LLC. All Rights Reserved. Life Fitness, Hammer Strength, Cybex, ICG and SCIFIT are registered trademarks of Life Fitness, LLC and its affiliated companies and subsidiaries. Brunswick and related trademarks used under license from Brunswick Corporation. (6.19)


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