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Receive
a new brand name computer.
Get
approved, even if you have bad credit or have filed for
bankruptcy.
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Computer
order application:
(Required
Fields are Bold)
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E-Mail
Address *
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First Name*
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Middle: |
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Last Name
*
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Address *
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City, St,
Zip *
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Years at
Current Address *
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Years
Months |
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Home Phone *
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Work Phone *
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Ext or Dept |
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Own or Rent
Your Home? *
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Social Security
Number
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| EMPLOYMENT
INFORMATION |
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Employer
Name *
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Employer
Address*
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Employer
City, St, Zip *
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Years at
Employer *
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Net Monthly
Income *
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Position *
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I
HAVE READ, UNDERSTAND AND AUTHORIZE THE FOLLOWING:
By
clicking the submit button, I hereby declare that I/We are
applying for an installment sales contract with Superior
Platinum Solutions LLC, and/or their agents/associate
companies. I understand that the Superior Platinum Solutions
LLC, and/or their agents, will order a copy of my credit
history to verify all information provided as well as
contact my employer to verify employment.
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