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Page 2 of a Credit Application Example

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Text in this example:

CREDIT APPLICATION APPLICATION INFORMATION CONTINUED Name of a relative not residing with you: Address: Phone: City: State: ZIP Code: Relationship: CREDIT CARDS Name Account Current balance Monthly payment MORTGAGE COMPANY Account no.: Address: AUTO LOANS Auto Loans Account no. Balance Monthly Payment OTHER LOANS, DEBTS, OR OBLIGATIONS Description Account no. Amount OTHER ASSETS OR SOURCES OF INCOME Description Amount per month or value I authorize [COMPANY NAME] to verify the information provided on this form as to my credit and employment history. Signature of applicant Date Signature of co-applicant, if for joint account Date

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