These can usually be downloaded from the Internet and used to get a general idea of how to make a credit application. Note that various companies usually provide their own credit application forms, therefore, do not use this template. It is meant to give you an idea of what to expect in an actual form.
Name: __________________________________________________________________
Date of birth: __________________________ phone no: _________________________
Social security no: ________________________________________________________
Address: _______________________________________________________________
EMPLOYMENT INFORMATION
Current employer
Name: ________________________________________________________________
Address: ______________________________________________________________
Telephone: ____________________________________________________________
Position: ______________________________________________________________
Salary: Hourly __________________________ monthly: _______________________
Previous employer
Name: ________________________________________________________________
Address: ______________________________________________________________
Telephone: ____________________________________________________________
Position: ______________________________________________________________
Salary: Hourly __________________________ monthly: _______________________
Do you have any other loans? ______________________________________________
With which company: ____________________________________________________
REFERENCES
Name 1: _____________________________________________________________
Address: ___________________________________________________________
Telephone: ___________________________ e-mail: ________________________
Name 2: _____________________________________________________________
Address: ___________________________________________________________
Telephone: ___________________________ e-mail: ________________________
Name 3: _____________________________________________________________
Address: ___________________________________________________________
Telephone: ___________________________ e-mail: ________________________
BANK DETAILS
Name of bank: ____________________________________________________
Name of branch: _____________________________________________________
Telephone: ________________________________________________________
Name of contact person: _______________________________________________
How much credit are you asking for? $ ___________________________________
___________________________________________________________________
Type of account: ? Savings ? Checking
OTHER INFORMATION
Have you ever filed for bankruptcy before?
Yes______
No_______
If yes, when? ______________________________________________________
Have you ever defaulted in payment of credit before? ? Yes ? No
If yes, give details: _________________________________________________
_________________________________________________________________
Signature: ________________________________ Date: ____________________
……………………………………………….
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