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  1.                      CONSUMER CREDIT APPLICATION
  2.  
  3.  
  4. Name _                                         Date _
  5. Address _                                             
  6. City _                       State _     Zip _
  7. How long at address _                      Own or Rent _
  8. Employed by _                              Position _
  9. How long _                                 Salary $_
  10. No. dependents _       Type car owned _        Year _
  11. Other sources of income:
  12.     _                                      $_
  13.     _                                      $_
  14. Outstanding obligations:
  15.     _                                      $_
  16.     _                                      $_
  17.     _                                      $_
  18.     _                                      $_
  19. Pending lawsuits: _
  20.                                         
  21. Have you filed bankruptcy within last 6 years? _
  22. Credit references:
  23. Name _                             Address _
  24. Name _                             Address _
  25. Name _                             Address _
  26. Bank references:
  27. Name _                             Address _
  28. Checking _                    Savings _
  29. Visa Card _                   Master Card _
  30. American Express _            Other Credit Cards _
  31.  
  32.  
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  35.                                 NOTICE
  36.  
  37.  
  38.  
  39.  
  40.      When making applicatin for credit, it is understood that
  41. an investigation may be made whereby information is obtained
  42. through personal interviews with your neighbors, friends, or
  43. others with whom you are acquainted.  This inquiry includes
  44. information as to your character, general reputation, personal
  45. characteristics, and mode of living.  You have a right to make
  46. a written request within a reasonable period of time to
  47. receive additional, detailed information about the nature and
  48. scope of this investigation.
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  55. __________________________________________
  56.                                        Applicant
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  59.