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  1.                    SAMPLE CREDIT QUESTIONNAIRE
  2.  
  3. Creditability and Reputation_________________________________
  4. How long have you worked with him?___________________________
  5. Highest credit on:  Charge account___________________________
  6. Highest credit on:  Installment credit_______________________
  7. Present amount owed:  Due now________________________________
  8. Present amount owed:  Past due_______________________________
  9. Meeting obligations promptly?________________________________
  10. Present Address______________________________________________
  11. Remarks______________________________________________________
  12. Signed________________________   Date________________________
  13.  
  14.  
  15. Length of time known?______________________ Age______________
  16. Single or married__________________________
  17. Character________________ Community Reputation_______________ 
  18. Occcupation______________ Employer's Name____________________
  19. Employment steady?_______ Monthly Income (estimate)$_________
  20. Amount owed you:  Due now$_______________ Past due$__________
  21. Meeting obligations promptly?________________________________
  22. Present Address______________________________________________
  23. Remarks______________________________________________________
  24. Signed_______________________    Date________________________
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