Arthur Glick Trucks -
FINANCIAL CREDIT APPLICATION (PLEASE PRINT OR TYPE)
PERSONAL INFORMATION
NAME:
First
Middle Initial
Last
Date of Application
Social Security Number
Date of Birth
No. of dependents
Marital Status
Married
Widowed
Single
Separated
Divorced
Address
Phone Number
City, State, Zip Code
How long at this address
How long in area
Yrs
Yrs
Former addresses (Five year minimum)
City, State, Zip Code
How long?
Yrs
Business name
Business Tax I.D. Number
Business Address (If different from above)
Business phone Number
EMPLOYMENT HISTORY FOR PAST FIVE YEARS (PRESENT OR LAST EMPLOYER FIRST)
1) Name and address of company
Phone no.
Position (s) Held
How long?
2) Name and address of company
Phone no.
Position (s) Held
How long?
3) Name and address of company
Phone no.
Position (s) Held
How long?
COMPLETE THIS SECTION ONLY IF THIS IS A JOINT APPLICATION WITH YOUR SPOUSE, OR IF YOU ARE RELYING ON YOUR SPOUSE'S INCOME OR ASSETS AS A BASIS FOR REPAYMENT OF THE CREDIT REQUESTED, OR IF YOU RESIDE IN COMMUNITY PROPERTY STATE
Spouse's name (First, M.I, Last)
Social security Number
Date of birth
Spouse's Employer
Position (s) Held
How long
Nearest relatives not living with you
Address
Relationship
SPOUSE
Have you ever taken bankruptcy?
Are you a defendant in any legal action?
Have you ever had any item repossessed
No
Yes - Explain Below
No
Yes - Explain Below
No
Yes - Explain Below
Explanation :
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