Rental Prepayment Request

for existing contracts.

This form is not for a new rental agreement signing up.

- - - Please choose desired number of months to prepay.
    - Please put the monthly total amount without a discount and tax. See your monthly billing email for the monthly fee amount (rental+insurance).
    - The calculated amount on this form is for your calculation/estimate purpose only and we will review this form and charge the amount base on the contract the number of months you choose on this form. You will receive an email confirmation after the payment with actual amount is processed.
    - If you do not know your monthly fee amount send us an email at centrevillemusic@gmail.com or call us at 703-988-0002.

Customer Information
Was the contract date before 7/16/2022?
Account Number ( Leave this section blank if you do not know)
Name (Name of the person who signed the contract. Do not use student's name.)*
First Last
Phone (Required for online request)
Instrument (select one) . If you have multiple instrument submit the form separately for each instrument.*
Email*
How many months prepayment you will pay ? (Required field for a request)*
The calculation is for your estimate purpose only. Actual amount will be charged based on the prices on the contract and how many months you requested. You can leave it blank or contact us to verify your monthly amount.
My monthly rental + insurance (Without the tax)
Total without a discount (+tax)
Total after a discount(+tax)
Total after a discount(+tax)
Total after a discount(+tax)
Total after a discount(+tax)
Total after a discount(+tax)
Savings after the discount(+tax)
Savings after the discount(+tax)
Savings after the discount(+tax)
Savings after the discount(+tax)
Savings after the discount(+tax)
Consent*
I understand that the rental contract is not a Rent-to-Own program and no portion of the payment will go to the purchase.*
Consent*
I understand if my contract was made on or after 7/16/2022 my rental contract is not a Rent-to-Own program and no portion of the payment will go to the purchase.*
Consent*
I request to make a prepayment on the rental instrument using the credit card on file. I understand that the prepayment is not refundable and I have a right to cancel the payment and switch to month-to-month contract within 30 days after making the payment.*
Customer's signature.*
Phone
This field is for validation purposes and should be left unchanged.

Table of Contents

Customer Information

The calculation is for your estimate purpose only. Actual amount will be charged based on the prices on the contract and how many months you requested. You can leave it blank or contact us to verify your monthly amount.