Customer Information Form

Micros Leasing

100% Financing Program

NO Advanced Lease Payments

Angela Blanch

Greg Hawthorne

Phone 888-428-4838

Fax 315-410-5322


Applicant Information (Fields marked with * are required)


Do You Own Additional Companies?

Personal Information of Officers/Partners/Owners - include all major owners' information (Optional)

Statement (Fields marked with * are required)

Customer authorizes Micros Leasing or its assigns to request, verify and review data or information about the customer, its officers, partners, owners and guarantors including reports from agencies and information from references. Micros Leasing is authorized to give credit information about customer to others. All information provided herein is correct and complete. If business credit is denied, customer has the right to a written statement of the specific reasons for the denial. To obtain this statement, please contact Micros Leasing at address shown above within 60 days of a denial. A fax or photocopy of this authorization shall be valid as the original.

Micros Leasing, a division of POS Credit Corporation
5786 Widewaters Parkway, DeWitt, NY 13214