CREDIT APPLICATION FOR HOME TANNING BED
Mother’s Maiden Name:
____________________________________________________ (or other code word
phrase for security purposes)
Address:
______________________________________________________________________________________
(include APT, LOT, etc.)
First:
_____________________________________
Middle: ______
Last:
_________________________________
Suffix: ___________
Social Security #:
_________________________________________
Date of Birth (MM/DD/YYYY):
_____________________________
Relationship to Applicant:
_____________________________________________________________________________________________
Address (write SAME
if same as above): __________________________________________________________
(include APT, LOT, etc.)
Rent/Buy/Own:
______________________________________________________________________________________________________
Mobile Home?
Y/N_______________________________________
Own/Rent the Land:
_______________________________________
Co-Applicant Annual Salary:
$_________________________________________________________________________________________
Other Income: $________________________________________***
Source of Other Income:
____________________________________
Total Household Income:
$_________________________________________________________________________________________
***
***Alimony, Child Support, or Separate Maintenance income need not be revealed
if you do not wish it considered as a basis for repayment.
Term of Loan: _____________ Requested Amount:
$__________________
Product Type:
90 SAC
180 SAC
You are 18 or older. You authorize
LENDER to check your credit, employment, and other information to process your
application, service your account, and manage its relationship with you.
You authorize LENDER to share information about you or your account with
others including The Independent Savings Plan Company, even if you later opt
your account out of information sharing with others.
Your right to opt your account out of some of this sharing is described
in the LENDER’s Privacy Notice. The
Privacy Notice will be delivered to you.
If approved, your account will be subject to the terms of the LENDER’s
Account Agreement, including arbitration and supplemental agreement terms.
If LENDER declines this application by signing below, you authorize ISPC at its
option, to forward this application together with all supporting documentation,
including any credit report to another lender for consideration.
You understand that a loan from a secondary lender may have different
terms and conditions than a loan from LENDER.
____________________________________________________
__________________________________________________________