RB Financing

1. I understand that this submitted form constitutes a legal, binding contract between Me and Rare Bulldogs *

E-mail Address: *

3. First and Last Name *

4. Street Address *

5. City, State, Zip *

6. All Contact numbers *

7. Employer: Name, address, phone. *

8. Do we have permission to contact your Employer? *

Yes
No

9. Bank Reference. Please list your banking institution, checking #, savings #. *

10. How much will you pay down? The amount discussed and agreed upon by you and Rare Bulldogs. *

10a. What is the Total Adoption or Stud Service Fee? *

11. Choose the number of months for balance payments. Your Monthly Payment Amount will be based on this choice. Stud Services cannot exceed 6 months. *

3 months
6 months
12 months
18 months
24 months

12. What day of the month do you want your Payments to be due? *

13. Do you understand and agree to our Late fee Policy of $25.00 every 10 days, added to your balance until account is brought current? *

Yes
No

14. Do you understand and agree that health, loss of pet by any means including lost, stolen, and death, does not release you from fulfilling this contract? These circumstances will be covered by our Guarantee. *

Yes
No

15. Do you understand and agree to all requirements listed above this form located at rarebulldogs.com/RB-financing.htm? *

Yes
No

16. Do you understand and agree that no papers or litter confirmations will be supplied to you until this contract agreement is fulfilled in full? *

Yes
No

17. Today's Date *

18. I swear that I am the Person(s) listed above *

19. I agree to be bound by all statements in this contract as of the submittal date of Today, governed by the State of Florida, county of Escambia. *

20. Clear, readable photos of your Driver License, Social Security Card, Current Utility bill with your name and address, and Auto Tag must be attached to this form for approval? *

Yes
No

Attach a File: Driver Liscense *

Attach a File: Social Security Card *

Attach a File: Current Utility Bill *

Attach a File: Auto Tag *

Verification Code: Visual Verification Image

Enter Verification Code: *

* Required