Business Information
Principal #1
Principal #2
Bank Information
Trade References
NamePhone NumberCityState
Equipment Description
Dealer Information
Debt Cancellation Options

NO, I do not want debt cancellation protection for my lease obligation.

YES, I want debt cancellation life protection for the person(s) named above as "Customer" & I also want debt cancellation total disability protection for the person whose name appears first as "Customer" on this application. The debt cancellation protection will only go into effect if this lease application is approved by Stearns Bank and the age and health of the applicant(s) qualify for the protection.
THIS PRODUCT IS OPTIONAL. YOUR PURCHASE OF DEBT CANCELLATION IS OPTIONAL. WHETHER OR NOT YOU PURCHASE DEBT CANCELLATION WILL NOT AFFECT YOUR APPLICATION FOR CREDIT OR THE TERMS OF ANY EXISTING CREDIT AGREEMENT YOU HAVE WITH US.

Signatures

Stearns Bank NA and/or its affiliates will be requesting information on all accounts maintained at your bank. Please accept this release as authorization to provide the requested information. Stearns Bank NA and/or its affiliates reserves the right to pull a credit bureau on all parties identified as principal(s) on the equipment leasing application.