The Applicant/Additional Applicant hereby acknowledge and recognize that this is an application for credit.By submitting this application, I (We) have verified that all information submitted on this application is true and correct to the best of our knowledge, as well as allowing CosmeticaPaymentPlus.com, and/or its Lender(s) and other 3rd Parties to verify the enclosed information, including, but not limited to,
obtaining our credit reports, contacting our employers to verify employment and income, and/or contacting our Physician to verify the type of procedure(s), procedure date, deposit amount, procedure amount, and remit payment upon approval. I (We) understand and agree that the Lender(s) [as defined in the Promissory Note or communicated to me] can furnish information concerning my/our account to consumer reporting agencies and others who may properly receive that information. By providing a telephone number for a cellular phone or other wireless device, I (We) are expressly consenting to receiving communications at that number, including, but not limited to, prerecorded voice message calls, text messages, and calls made by any representatives from CosmeticaPaymentPlus.com and/or its Lender(s) and other 3rd Parties. This express consent applies to each such telephone number that I (We) provide to CosmeticaPaymentPlus.com and/or its Lender(s) now or in the future and permits such calls regardless of their purpose. These calls and messages may incur access fees from my/our cellular provider. I (We) understand that we may opt out of this authorization by providing written notice to the parties herein. If approved for a revolving account, a credit card will be issued in either the Applicant or Additional Applicant’s name only, and it will be sent to the home address on the application. APR’s will vary depending upon credit ratings and/or payment terms that are approved. Credit approvals are valid for a limited time only. Certain fees may apply. By signing, I (We) certify that I (We) have read, agree to, and understand the disclosures herein and I(We) agree to the terms of this application and that a physician staff member may apply on our behalf.