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| Consumer Credit Application |
Consumer Credit ApplicationName _____________________________Date_______________ Address____________City___________State______Zip_____ How long at address_______________Own or Rent _______ Employed by____________________________Position______ How long____________________________Salary $_________ No. dependents__________Type car owned______Year_____ Other sources of income: _________________________________ $__________________ _________________________________ $__________________ Outstanding obligations: _________________________________ $__________________ _________________________________ $__________________ _________________________________ $__________________ _________________________________ $__________________ Pending lawsuits_____________________________________ Have you filed bankruptcy within last 6 years?_______ Credit references: Name_____________________Address_____________________ Name_____________________Address_____________________ Name_____________________Address_____________________ Bank references: Name_____________________Address_____________________ Checking_____________Savings_________________________ Visa Card____________Master Card_____________________ American Express_____Other Credit Cards______________ NOTICE When making application for credit, it is understood that an investigation may be made whereby information is obtained through personal interviews with your neighbors, friends, or others with whom you are acquainted. This inquiry includes information as to your character, general reputation, personal characteristics, and mode of living. You have a right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of this investigation. ________________________________ Applicant |