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Application for Lease — Option to Purchase





Four References Mandatory


If Yes,

By signing below, you acknowledge that you have understood each question on this Application and the Terms set out below, and that all information contained herein is true and accurate to the best of your knowledge. Further, you represent that Local Tire & Wheel, LLC can rely on the information contained herein to determine your eligibility for a Lease — Option to Purchase Agreement.


The Application should be signed by all Applicants (individuals signing the Application) prior to entering into a Lease Agree — Option to Purchase Contract. Local Tire & Wheel, LLC and its employees, agents, and representative (hereinafter referred to collectively as Local Tire & Wheel) is expressly relying on representations made by Applicants to determine eligibility. Applicants agree and acknowledge the submission of the Application without a signature is still binding in all respects against Applicant.

Applicant(s) hereby consent to the use of an electronic signature to sign this Application and any or all other documents provided by Local Tire & Wheel including a Lease — Option to Purchase Agreement.

Applicants who fail to sign the Application expressly acknowledge that the failure to sign shall not be used in whole or in part as the basis of any claim against Local Tire & Wheel.

All Applicants expressly authorize Local Tire & Wheel the right to validate any and all information provided on the Application, including verification of employment, references, or banking information.

All Applicants agree to hold Local Tire & Wheel harmless for any and all claims, harm, or causes of action, at law or in equity, resulting from actions taken by Local Tire & Wheel to verify any information provided herein.

All requested information on the Application should be completed. Any information left blank may prevent Local Tire & Wheel from being able to process the Application and could result in an Applicant(s) failing to qualify for a Lease — Option to Purchase Agreement.

Local Tire & Wheel is not obligated to enter into a Lease — Option to Purchase Agreement with any Applicant merely by accepting an Application. All Applicants must meet the standards set by Local Tire & Wheel to qualify.

Applicant is entitled to a copy of this Application by way of email. If Applicant would like a paper copy of this Application they may print a copy or request a copy from Local Tire & Wheel. Applicant agrees to pay any applicable service fee for printing the Application.

Applicant authorizes any notices that may be sent or required to be provided to one or more of the email addresses provided in the Application. All Applicants acknowledge that Local Tire & Wheel is in full satisfaction of any notice requirement at law or any agreement executed with Local Tire & Wheel by sending the notice via email.