Please fill out this Application completely
and submit it. Upon receipt of your Application, it will be reviewed by
us. Additional documentation may be requested.
APPLICANT INFORMATION
CO-APPLICANT
Applicant's Name :
Age:
Home Phone Number :
(include area code)
Social Security Number :
Present Address :
(street, city, state, zip code)
Own/Rent :
Years :
Co-Applicant's Name :
Age:
Home Phone Number :
(include area code)
Social Security Number :
Present Address :
(street, city, state, zip code)
Own/Rent :
Years :
Borrower
EMPLOYMENT INFORMATION Co-Borrower
Name & Address of
Employer :
Self Employed
:
Yrs. on this Job :
Yrs. in this line of work
:
Position/Type of Business
:
Business Phone :
(include area code)
Name & Address of
Employer :
Self Employed
:
Yrs. on this Job :
Yrs. in this line of work
:
Position/Type of Business
:
Business Phone :
(include area code)
Gross Monthly
Income :
Savings / Cash
and Checking :
Stocks / Bonds :
Retirement :
Total Fixed
Monthly Payments :
Total Credit
Card Debt :
PURCHASE SECTION
Desired City :
Purchase Price Range :
E-Mail Address :
Rate Your Credit :
The above information is correct
to the best of our knowledge and we intend it to be relied upon for the
purpose of this application. By submitting this form, we the undersigned
hereby give our consent to have American Discount Lenders, its agents and
/ or any credit reporting bureau which it may designate, obtain any and
all information concerning the above application. Additional information
will be requested by American Discount Lenders for complete processing,
when we apply with this short form application.
AUTHORIZATION
By submitting this form, I / we hereby
authorize release of information pertaining to employment, income, banking,
or credit ratings to American Discount Lenders in connection with my / our
pending grant application. I / we acknowledge that no promises have been
made by American Discount Lenders regarding the approval of my/our
request..