Credit Application Template



Contoso, Ltd.Credit ApplicationApplicant InformationName:Date of birth:SSN:Phone:Current address:City:State:ZIP Code:OwnRent(Please circle)Monthly payment or rent:How long?Previous address:City:State:ZIP Code:OwnedRented(Please circle)Monthly payment or rent:How long?Employment InformationCurrent employer:Employer address:How long?Phone:E-mail:Fax:City:State:ZIP Code:Position:Hourly Salary(Please circle)Annual income:Previous employer:Address:How long?Phone:E-mail:Fax:City:State:ZIP Code:Position:HourlySalary(Please circle)Annual income:Name of a relative not residing with you:Address:Phone:City:State:ZIP Code:Relationship:Co-Applicant Information, if for a joint accountName:Date of birth:SSN:Phone:Current address:City:State:ZIP Code:OwnRent(Please circle)Monthly payment or rent:How long?Previous address:City:State:ZIP Code:OwnedRented(Please circle)Monthly payment or rent:How long?Employment InformationCurrent employer:Employer address:How long?Phone:E-mail:Fax:City:State:ZIP Code:Position:Hourly Salary(Please circle)Annual income:Previous employer:Address:Phone:E-mail:Fax:City:State:ZIP Code:Position:HourlySalary (Please circle)Annual income:Application Information ContinuedName of a relative not residing with you:Address:Phone:City:State:ZIP Code:Relationship:Credit CardsNameAccount no.Current balanceMonthly paymentMortgage CompanyAccount no.:Address:Auto LoansAuto loansAccount no.BalanceMonthly paymentOther Loans, Debts, or ObligationsDescriptionAccount no.AmountOther Assets or Sources of IncomeDescriptionAmount per month or valueI authorize Contoso, Ltd. to verify the information provided on this form as to my credit and employment history.Signature of applicantDateSignature of co-applicant, if for joint accountDate ................
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