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(Community property)

CREDIT APPLICATION

IMPORTANT:Read these directions before completing this Application.


If you are applying for individual credit in your owm name, are not married, and are not relying on alimony, child support, or separate maintenance payments or on the incom or assets of another person as the basic for repayment of the credit Box requested, complete only Section A ans D. If the request credit is to be secured, also complate Section E.

In all other situations, complete all Sections except E, providing information in B about your spouse, a joint apllication or user, or the person on whose alimony, support, or maintenance payments or incom or assests you are relying. If the request credit is to be secured, also complate Section E.

Amount Request

Payment Date Required

Proceeds of Credit

Section A-Information Regarding APPLICANT

Alimony, child support or seperate miantenance income need not be reveald if you do not wish to have it considered as a basis for this obligation.

Alimony, child support or seperate miantenance received under:

If any income listed in this Section likely to be reduced in the next two year or before the credit requested is paid off?

Section B-Information Regarding Spouse, joint applicant, udser, or other party

Alimony, child support or seperate miantenance income need not be reveald if you do not wish to have it considered as a basis for this obligation.

Alimony, child support or seperate miantenance received under:

If any income listed in this Section likely to be reduced in the next two year or before the credit requested is paid off?

Section C-Marital Status

Section D-Asset and debt information

(if sec B has been completed. this section should be completed giving information abot both the applicant an spouse. joint applicant , user or other person. plese mark Applicant-related information with an "A" if section B was not completed only give information about the applicant in this section.)

Privacy Policy

Applicant's Signature *  x

Other Signature (Where Applicable) *  x
Please check * I have read and accept the above policy.