7022364114
munari@msn.com
Credit Application IMPORTANT: READ THESE DIRECTIONS BEFORE COMPLETING THIS APPLICATION purchaselease SECTION A. Check appropriate box If you are applying for individual credit in your own name and are relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit requested.If you are married and live in a community property state, complete all sections, including Section C, providing information about your spouse.If this is an application for joint credit with another person, complete all sections, providing information in Section C about the co-applicant.
NOTE: APPLICANT, IF MARRIED, MAY APPLY FOR A SEPARATE ACCOUNT. Seller Stock number/year & make Date Amount requested in $
SECTION B. Information Regarding Applicant
Your name & social security number Birth Date Home Telephone/Cell Your Email (required)
Your address & years there (required) Years lived in this community (required) Previous address & years there (required) Years lived in this community (required) Present employer & telephone number (required) Present employer's address (required) Position - title -years employed (required) Previous employer/title/years employed (to cover previous two years)
Name of nearest relative not living with you/address/phone/relationship Applicant's gross monthly income from employment. (Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.) Gross monthly income Alimony, child support, or separate maintenance received under: court orderwritten agreementoral understanding
Amount of other monthly income & sources
SECTION C. Information Regarding Spouse, or Co-Applicant (if necessary) Name/address/birth-date/driver's license #/ss#/dependents & ages Marital status marriedunmarriedseparated How long at this address (in years & months) How long in community Previous address (to cover 3 years residence)
Co-applicant's-present employer's address/phone (required) Co-applicant's Position - title -years employed (required) Co-applicant's Previous employer/title/years employed/phone (to cover previous two years)
Co-applicant's name of nearest relative not living with you/address/phone/relationship Co-applicant's gross monthly income from employment. (Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.) Gross monthly income Co-applicant alimony, child support, or separate maintenance received under: court orderwritten agreementoral understanding
Co- applicant amount of other monthly income & sources SECTION D. Asset and Debt Information: List all debts including alimony, child support, separate maintenance(Be specific & complete) (If Section C has been completed, this section should be completed giving information about both the Applicant and the Co-Applicant, or other person. Please mark Applicant related information with an "A". If Section C was not completed, only give information about the Applicant in this Section)
Name of Landlord or Mortgage holder Address First Mortgage balance Payment?Rent? First mortgage payment amount in $ 2nd mortgage payment amount in $ Date home purchased Age of home Purchase price home Estimated value of home Furniture owned in 'Number of Rooms?' To whom balance of furniture owed? Balance owed Estimated value Vehicles/Purchased from/Address/Purchase price/Monthly payment
Bank reference #1/Branch/Account number CheckingSavingsLoan Balance? Bank reference #2/Branch/Account number CheckingSavingsLoan Balance? Bank reference #3/Branch/Account number CheckingSavingsLoan Balance? HAVE YOU EVER HAD ANY PROPERTY REPOSSESSED? YesNo DO YOU HAVE ANY PENDING LAWSUITS?? YesNo HAVE YOU FILED BANKRUPTCY IN THE LAST FOUR YEARS? YesNo MILITARY RESERVE? YesNo ACTIVE? YesNo INACTIVE? YesNo
Name of friend #1/Address/City/State/Zip/Telephone Estimated value
Name of friend #2/Address/City/State/Zip/Telephone Estimated value
SECTION E. INSURANCE-IF YOU WISH TO APPLY FOR VEHICLE INSURANCE IN CONNECTION WITH THIS CREDIT APPLICATION, COMPLETE THE FOLLOWING: Note: No person is required as a condition precedent to financing the purchase of a vehicle to purchase insurance through a particular insurance company, agent or broker. Previous insurance agent name/Address/Policy number Where will vehicle be garaged? Has your insurance ever been cancelled by any company? YesNo If so, why?? Number of losses in the last 5 years. Total $ amount of losses. SECTION F. The undersigned (1) makes the above representations, which are certified to be correct, for the purpose of securing credit, (2) authorizes the Financial Institution to gather whatever credit and employment history it considers necessary and appropriate, and also approves the Financial Institution to give information concerning the transaction to others, and (3) understands that we will retain this application whether or not it is approved. The Financial Institution named below may be requested to purchase a sales finance contract written, or to be written, in conjunction with your purchase. You are notified pursuant to the Fair Credit Reporting Act that your application may be submitted to them. Name of FINANCIAL INSTITUTION/ADDRESS PURCHASER HEREBY ACKNOWLEDGES RECEIPT OF A COPY OF THIS CREDIT APPLICATION/STATEMENT X APPLICANT'S SIGNATURE X OTHER SIGNATURE
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