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Form #1380CREDIT APPLICATION (FORM B)
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CREDIT APPLICATION (FORM B)
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CREDIT
APPLICATION (FORM B)
Legal Name of Applicant:
_______________________________________________
Present Address:
_______________________________________________________
Home Phone: ______________________ Work
Phone: _______________________
HOME DATA
Do you rent or own? ( ) rent ( )
own
How long have you lived at your
present address? __________
Previous addresses and dates you
lived there:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
WORK DATA
Are you employed? _____ (If you own
your own business, go to Business Data section)
If employed, what is your present
employment?
_______________________________________________________________
Name and address of employer:
_______________________________________________________________
How long have you worked for this
employer?
_______________________________________________________________
If employment has been less than one
(1) year, list previous employment?
_______________________________________________________________
BUSINESS DATA
What type of business are you engaged
in? _______________________________________________________________
Name and address of business:
_______________________________________________________________
How long have you owned this
business? _______________________________________________________________
What is the legal organization of
this business? _______________________________________________________________
If business has been less than one
(1) year duration, what was your prior working/business affiliation?
_______________________________________________________________
ANNUAL INCOME
Gross income from work or business?
______________________________________
Overtime or outside income?
______________________________________
Interest and/or dividends?
______________________________________
Commissions or fees?
______________________________________
Rentals from property?
______________________________________
Other Income (specify)?
______________________________________
Total Annual Income:
______________________________________
ESTIMATED VALUE OF YOUR POSSESSIONS
Equity in
home:_____________________________
Equity in other property:
______________________
Car(s):____________________________________
Savings:
__________________________________
Stocks/bonds:
______________________________
Total Assets:
_______________________________
ESTIMATED DEBTS
Mortgage balance:
___________________________
Car loan:
__________________________________
Bank
loan:_________________________________
Credit card(s):
______________________________
Other:
_____________________________________
Total Debts:
____________________________
BANKRUPTCY
Have you ever found it necessary to
declare bankruptcy during the past five (5) years?
( ) yes ( ) no
What was the date? _______________
CERTIFICATION
I certify the aforegoing information
to be accurate and complete to the best of my knowledge and hereby authorize
the disclosure and release of any credit-related information based on this
application to _______________________________
______________________________________________________________.
Signed:________________________________
Date:___________________
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or any other commercial use is prohibited. This includes reposting forms from this
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Your use of this site constitutes your acceptance of our terms of use and your agreement
to hold this site, its officers, employees and any contributors to this site harmless
for any damage you might incur from your use of any submissions contained on this
site. If you do not agree to the above terms, please do not proceed.
These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com
is not engaged in recommending or referring members on the site or making claims
about the competence, character or qualifications of its participating members.
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Keywords: CREDIT,APPLICATION
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