Commercial Arcade Game / Vending Machine Leasing Financing Application

     Here you can apply for arcade game and vending leasing from one of our many equipment leasing partners.
     Arcade game leasing makes a great choice for equipment acquisitions by being more cost effective than outright
     purchasing, through low, tax deductible, monthly payments and using a financing method that does not tie up any
     existing credit lines! You can get approved fast, bundle in shipping costs, and buy with confidence and security!

        Please complete this short form below to apply for arcade games and vending machine financing :


Applicant Information
Your Full Name :
Your Business Address :
Additional Address Info :
City :	State : Zip Code :
Your Phone Number :
Your Email Address :
How did you hear about Us :
Best Time to Contact You ?	Best Way to Contact You ? :

Your Business Information
This application is for a :	New Business / Location Existing Business / Location
BMI Gaming Customer Status :	New Customer Current Customer Past Customer (Over 1 Year since last order)
Your Social Security Number :
Legal Business Name :
Type Of Business :	If Other :
Annual Revenues :	(Gross Dollar Sales for Past 12 Months, Enter $0 if New Business)
Number of Employees :	(Enter at least 1 for yourself)
Years in Business :	(Enter 0 If New)
Number of Other Locations :	(Enter 0 If None)
Type of Equipment Now Owned :	Amusements or Games Vending Machines Amusements & Vending
Approximate Number of Games you are Looking to Finance :
Approximate Dollar Amount of Order :	(Minimum $10,000)
When Do You Plan To Purchase ? :
Do you have any business partners or investors ? If so, please enter the details below :
Principal # 2 Full Name ?
Principal # 2 Social Security # ?
Principal # 3 Full Name ?
Principal # 3 Social Security # ?
Description of Arcade Game / Vending Machine Financing Needs

I submit that this information is true and complete, and grant authorization for BMI Worldwide, Inc., its affiliates
and its third party finance vendors to inquire about credit experience and to make inquiries of
credit reporting agencies and authority is granted for the furnishing of this information.

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 BMI Worldwide within 60 days from the day 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 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):
familial status, sexual orientation, ancestry, handicap or whether or not all or part of the person's income derives from any public assistance program, or whether 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 Federal Deposit Insurance Corporation,
15 Braintree Hill Office Park, Braintree, MA 02184. The state agency that administers compliance with the state law in
Massachusetts is the Commission Against Discrimination, One Ashburton Place, Boston, MA 02108

Please click on the "Submit Form" button below to complete your inquiry.
Be patient - It can take up to one minute to process this form and your inquiry completely.

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