I/we hereby authorize you to whom this application is made, or your agents, to investigate my/our credit worthiness and will provide financial statements, tax returns, etc., as deemed necessary. I/we agree that if any applicable advance payments under the lease are made, I understand those payments are not refundable unless the lessor rejects the application.

By the execution of the lease agreement, I/we warrant that the information submitted herein is true and correct and hereby authorize references contained herein to release any necessary information. Further, I/we warrant it is understood that lessor reserves the right to reverse any credit decision if the information contained herein is found to be incorrect, and I/we will indemnify lessor for any and all costs incurred with this application for credit including any cost incurred in the placement or reservation of the intended leased or financed equipment based on the information contained herein. This application may be executed by facsimile signature(s), electronic signatures, Docusign, WP E-signature ApproveMe, and/or electronic signature via MedLaser USA website via WP E-signature Approve Me. I understand that WP E-Signature by Approve Me is legally binding and WP ESign is (UETA) & (ESIGN) compliant & adheres to the strictest document signing policy’s in the US & European unions. Delivery of this application bearing an electronic signature shall have the same force and effect as if the application bore an inked original signature(s). The above information, together with any accompanying financial statements, schedules, or other materials, is submitted for the purpose of obtaining credit and is warranted to be true, correct and complete. The undersigned understands that submission of this application does not guarantee an approval. The undersigned hereby warrants that any individual identified above who is either a principal, a personal guarantor or a sole proprietor of the credit applicant, recognizing that his or her individual credit history may be a factor in the evaluation of the credit history of the applicant, has provided his/her written authorization for inquiry into their credit worthiness, including but not limited to obtaining a consumer credit report, and shall hold MedLaser USA and its assignees, agents or nominees harmless from same. MedLaser USA has the right to use your credit information to secure funding by any lender deemed necessary and submit on my/your behalf.