CONSUMER CREDIT APPLICATION
Name _ Date _
Address _
City _ [...]

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CONSUMER CREDIT APPLICATION
Name ___________________________________________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 applicatin for credit, it is understood that
an investigation may be made whereby information [...]

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