home *** CD-ROM | disk | FTP | other *** search
/ ftp.wwiv.com / ftp.wwiv.com.zip / ftp.wwiv.com / pub / BBS / CREDIT.ZIP / CREDIT.TXT < prev    next >
Text File  |  1992-10-14  |  3KB  |  85 lines
  1.                             ENTERLINK TECHNOLOGY
  2.                           CREDIT REQUEST FORM 1.0
  3.                                 P.O. BOX 269
  4.                         SAN BERNARDINO, CA 92402-0269
  5.                              (800) 659-6516 VOICE
  6.            "SYSOP PLEASE CALL AND GET CURRENT FAX NUMBER TO PLACE HERE"
  7.  
  8.  
  9. I give EnterLink Technology, Inc. and "PUT YOUR BBS NAME HERE" permission to 
  10.  
  11. run credit report(s) on ^_______________________________________.  I understand
  12.  
  13. that the credit report that I receive is to be used for legal purposes and
  14.  
  15. that I will not add, change, delete any of the information on my credit report.
  16.  
  17.  
  18.  
  19. First Name:_____________________________  Last Name:_________________________
  20.  
  21. Middle Intial:______  Birth Date:_____/_____/____  SSN:______-______-________
  22.  
  23. Street Address:______________________________________________  Apt:__________
  24.  
  25. City:__________________________________   State:_____________  Zip:__________
  26.  
  27. Home Phone:____________________________   Work Phone:________________________
  28.  
  29. Previous Address if less than 2 years from above address
  30.  
  31. Street Address:______________________________________________  Apt:__________
  32.  
  33. City:__________________________________   State:_____________  Zip:__________
  34.  
  35. Occupation:____________________________
  36.  
  37.  
  38.   State ID   Or Driver License Picture Here
  39.   __________________________________________
  40.   |                                        |
  41.   |                                        |
  42.   |                                        |
  43.   |                                        |
  44.   |                                        |
  45.   |                                        |
  46.   |                                        | 
  47.   |                                        |
  48.   |                                        |
  49.   |                                        |
  50.   |                                        |
  51.   |                                        |
  52.    -----------------------------------------
  53.  
  54.  
  55. By signing below you swear under the law of purgery that all information is 
  56. above is correct. 
  57.  
  58. ____________________________________________      ______________________
  59.                Sign                                          Date
  60.  
  61.  
  62.  
  63. PAYMENT TYPE: VISA ( )  MASTERCARD ( )  COD ADD $5. FOR SHIPPING ( )
  64.  
  65.  NAME AS IT APPEARS ON CARD:___________________________________________________
  66.  
  67.  MASTER CARD:__________________________________________________________________
  68.  
  69.    EXP. DATE:______________
  70.  
  71.  
  72.  
  73. ID#:"SYSOP PLEASE PLACE THE ID# THAT ENTERLINK GIVES YOU HERE"
  74.  
  75.  
  76.  
  77. DO NOT SIGN OR TYPE BELOW OF THIS LINE.
  78. -------------------------------------------------------------------------------
  79.  
  80. DATE RECEIVED REQUEST:_________/__________/____________
  81.  
  82. REPORT GENERATED BY:___________________________________
  83.  
  84. BBS ID#:"PUT YOUR ID NUMBER HERE"
  85.