Sunday September 05
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CREDIT APPLICATION

All Loans Are Based Upon Approved Credit

Consumer's Statement Application For Credit

Surname

First Name & Initial(s):

Address:

City/Town:

Prov/State:

Postal/Zip Code:
Telephone (Home):
Telephone (Work):
Social Insurance #:
Driver's License #:

Years At Current Residence:

Residence:
 Own Rent
 

Relationship Status:

# Of Dependents:

Spouses Full Name

Spouses SIN #:
 

Your Occupation

Employer:

Years of Service:

Gross Monthly Income:

Spouse's Occupation

Employer:

Years of Service:

Gross Monthly Income:

Additional Comments:


 Have you ever had a car or any other merchandise repossessed? Yes No
 Have you ever declared bankruptcy? Yes No
 Have you made all of your payments on-time for the past 7 years? Yes No
 Have you ever been refused credit? Yes No

Applicant Authorization:
By submitting this form you are in agreement with....
 L & M Financing Services Corp. and all affiliated finance institutes may obtain credit information about me from my employer, any credit bureau or any other person in connection with my conditional sales agreement, and may disclose (automatically or upon request) credit information about me to credit bureau and to persons with whom I may have or propose to have financial dealing or if it believes the disclosure is required by law.

 
Thank You ~ L & M Financing Services Corp.
 
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