Free Credit Application Form
CREDIT APPLICATION
Name:
__________________________________________________________________
Date:
___________________________________________________________________
Present Address: _________________________________________________________
No.
Years:
_______________________________________________________________
Own or Rent:
_____________________________________________________________
No. of Dependents:
________________________________________________________
Name and
address of
employer: ______________________________________________
Years employed in this
type of work or profession: ________________________________
Years
on this job: __________________________________________________________
Position/Title:
_____________________________________________________________
Type
of business: _________________________________________________________
Home
phone: _____________________________________________________________
Business
phone: ___________________________________________________________
Gross
monthly income: _____________________________________________________
Base
employment income: ___________________________________________________
Overtime:
_________________________________________________________________
Bonuses:
_________________________________________________________________
Commissions:
_____________________________________________________________
Dividends/Interest:
__________________________________________________________
Net
Rental Income:
__________________________________________________________
Other
Sources: _____________________________________________________________
(Alimony, child
support or separate
maintenance income need not
be
revealed if the Borrower does not choose to
have it considered
as
a basis for repaying this loan.)
If
employed in present
position less than two years
state:
_____________________________________________________________________
Previous
employer: __________________________________________________________
Type
of business:
____________________________________________________________
Position:
___________________________________________________________________
Dates
from/to: _______________________________________________________________
Monthly
income: _____________________________________________________________
Have
you declared or been
declared bankruptcy in the past
five
years?:
_________________________________________________________________
Are
you a party to any
lawsuit?: _________________________________________________
ASSETS:
___________________________________________________________________
DEBTS:
____________________________________________________________________
Checking and Savings
Accounts: ________________________________________________
Loans:
_____________________________________________________________________
Stocks
and Bonds: ___________________________________________________________
Notes:
_____________________________________________________________________
Credit
Cards: ________________________________________________________________
Real
Estate Owned: __________________________________________________________
Retirement
Fund: ____________________________________________________________
Net
Worth of Business
Owned: __________________________________________________
Automobile
(make and
year): ____________________________________________________
Other:
_______________________________________________________________________
___________________________________
Borrower
