Lease application terms

I HEREBY: (1) certify that all information I have provided on this application or in connection herewith is true, correct, and complete; (2) consent to receive the disclosures contained in the application electronically; (3) understand and agree that FizzQuench may contact any person, company, or entity listed herewith for information about me and I fully release all parties from all liability for any damages that may result; (4) authorize FizzQuench to charge any bank account, credit card, or debit card (as described in the application) in the amount of my initial payment if my application is approved and I execute a lease-purchase agreement with FizzQuench authorizing such a charge; (5) understand that this application is subject to approval by Acima; (6) provide “written instruction” to Acima under the Fair Credit Reporting Act authorizing FizzQuench to obtain information from my personal credit report, personal credit profile, or other information from Experian and other agencies, and authorize FizzQuench to obtain such information solely to evaluate the terms of any merchandise lease offer and to confirm my identity to avoid fraudulent transactions in my name; (7) understand and agree that Acima may obtain a consumer report in connection with (a) my application, and (b) any updates, renewals, or extensions of any transaction resulting from my application or directly related to it; (8) understand that, if I ask, I will be informed whether or not such a report was obtained and, if so, the name and address of the agency that furnished the report; (9) authorize FizzQuench to share information with its affiliates for marketing purposes, and with the participating host retailer (“Retailer”) about Acima’s decision to offer me a rent-to-own transaction, and authorize FizzQuench to share my application information and lease terms with Retailer; and understand that I can withdraw my consent by closing this web session without submitting my application; and (10) understand that clicking the submit button below is the equivalent of my electronic signature on this application, and that I consent to be bound by the terms and conditions and important disclosures of the application.