The Mansion Furniture, LLC
Credit Application

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Must answer all four questions ("yes" or "no")
Have you been employed with the same company for at least 6 months?  
Do you earn $1,000 per month and deposit at least $500 per month into your checking account?
Do you have an active checking account and has it been open 3 months with at least 5 transactions in the last 30 days?
Does your checking account have any NSFs or excessive overdrafts in the last 30 days

Has a co-applicant

Co-applicant's Name
*Co-applicant must fill a separate form
Amount Requested

 

Yes / No  

Applicant Information
Last Name First Name Middle Name Social security number Date of birth mm/dd/yy
Address Apt # City State Zipcode
Driver license or government ID State ID issued Do you rent or you own? Months at residence
Phone # Cell Phone # E-mail address  
 

Employer Information
Employer Name (SS, Disability, Military, Self-employed) Job title Hire date mm/dd/y
Employer address Ste # City State Zipcode
Supervisor name Employer phone # Monthly income Last payday Next payday
  Payment frequency  
Receive direct deposit (Monday /Tuesday /Wednesday /Thursday /Friday /Saturday /Sunday)
Yes / No Weekly /Bi-weekly /Semi-monthly / Monthly
   
Do you have other income (all that apply) Net monthly income amount
( Social security /Disability /Military /Alimoni / Child support )
   
Bank Information
Bank Name Account # Routing # Open date mm/dd/yy
       

References (List of 5 relatives not living with you)
Last Name/ Name: Phone: City, State Relationship
Last Name/ Name: Phone: City, State Relationship
Last Name/ Name:

Phone:

City, State Relationship
Last Name/ Name: Phone: City, State Relationship
Last Name/ Name: Phone: City/State Relationship

By submitting this credit application form. I Hereby

(1) I certify that all the information I have provided on this application or in connection here with is true, correct and complete. (2) Understand and agree The Mansion Furniture, LLC and/or its financing companies may contact any person or company listed herewith for any information about me and I fully release all parties from any liability from any damage that may result. (3) Understand this application is subject to approval by The Mansion Furniture, LLC and/or its financing companies and that payments are remitted to the corresponding financing company (4) Understand and agree that The Mansion Furniture, LLC and/or its financing companies may obtain a consumer report in with (a) my application (b) any updates, renewals or extensions of any transaction as a result of my application of any other transactions hereto related. (5) Understand that if I ask, I will be informed wether or not such a report was obtained and, if so, the name and address of the agency that furnished the report.

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