Apply For Credit
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| Name:________________________________Employer Name__________________________ Social Sec. #__________________________ Employer Address:________________________ Position:________________________________ Years There: ____________________________ Previous Employer Name___________________ Address:________________________________ Street Address:_________________________ (If less than 2 Years) City/State/Zip:__________________________Years There:______________ Years There: ___________________________*Gross Monthy Income:______________________ MortgageHolder/Landlord:_________________________________________________________ Mailing Address:________________________________________________________________ (If Different) Previous Address:______________________________________________________________________ (If Less Than 2 Years At Present) CheckingAccounts:______________________________Bank:____________________________ Savings:______________________________ Bank:___________________________________ Credit References:______________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________ (List creditors, including Banks, Finance Companies, and Credit Cards. Please Also List any Obligations to Pay Child Support or Alimony)______________________________________________________________________ ______ *I authorize the Retailer (Dealer), its agents or assigns that has received and is processing this application to make or have made any credit, employment or investigative inquiry that is appropriate for the extension of credit or the collection of amounts owed. You can furnish information concerning my account to consumer reporting agencies and others who may properly receive that information. If I ask, I will be informed whether or not a consumer report was requested, and if a report was requested, I will be informed of the name and address of the consumer reporting agency that furnished the report. I agree that my application will remain the property of the Dealer, its agents or assigns. I certify that no essential or material information has been concealed and that no misrepresentations have been made in this application. |
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