Consent For Credit

*Full Name:

*Social Security #:

- -

*Date of Birth:

Co-Borrowers Full Name:

Co-Borrowers Social Security:

- -

Co-Borrowers Date of Birth:

*Current Address:

*How long at this address?:

*City:

*State:

*Zip:

*Rent or own?:

*Current Payment:

$

IF LESS THAN 2 YEARS GIVE PREVIOUS ADDRESS.

Previous Address:

City:

State:

Zip:

*Daytime Phone:

- -

Evening Phone:

- -

Other Phone:

- -

Borrower Email Address:

*Borrowers Employer:

*Salary:

*Years on Job:

IF LESS THAN 2 YEARS LIST PREVIOUS EMPLOYER.

Borrower Previous Employer:

Years on Job:

Phone:

- -

Co-Borrowers Employer:

Co-Borrower Salary:

Years on Job:

IF LESS THAN 2 YEARS LIST CO-BORROWERS PREVIOUS EMPLOYER

Co-Borrower Previous Employer:

Years on Job:

Phone:

- -

Realtor:

Realty Company:

Realty Phone:

- -