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*Date
of Application:
*Type of Application:
Personal
Business
*Name:
*Date of Birth (mm/dd/yyyy):
*Age:
(applicant must be 18 or older)
* Social
Security Number:
*E-mail
Address:
Current Address:
* Street
Address:
Address 2:
*City:
State:
Zip Code:
* Do
you currently:
Rent
Own *
Time
at Present Address:
Years
Months
*Home
Phone: (inc.area code)
* Work Phone:(inc.area code)
Previous Address: ( If present
address less than 2 years)
Address:
Address
2:
City:
State:
Zip Code:
Did You:
Rent
Own
Time at
Previous Address:
Years
Months
Applicant Employment
Present Employer:
*Company:
* Address:
Address
2:
*City:
State:
Zip Code:
*Position:
*Department :
*Supervisor:
*Income:
* Pay Period:
Weekly
Monthly
*Time
with current employer:
Years
Months
Credit History
Banking:
*Type of Account:
Savings
Checking
Credit Card
Other
*Bank
or Company:
* Location
(city and state):
Type of Account:
Savings
Checking
Credit Card
Other
Bank
or Company:
Location
(city and state):
Type of Account:
Savings
Checking
Credit Card
Other
Bank
or Company:
Location
(city and state):
Type of Account:
Savings
Checking
Credit Card
Other
Bank
or Company:
Location
(city and state):
Other Credit references:
1). Credit with:
Type of Credit:
Location (city and state):
2). Credit with:
Type of Credit:
Location (city and state):
3). Credit with:
Type of Credit:
Location (city and state):
4). Credit with:
Type of Credit:
Location (city and state):
Additional Comments: (place any
other comments here)
All payments due on the 10th of
each calendar month, you may select a different due date here, (if none
selected the due date will be the 10th of the month). I would like my payments
to be due on the
of the month for 12 months.
Our Credit terms are as follows:
The APR is 18% (1.5% per month)
all contracts are based on a 12 month term length. Unless otherwise requested
no contract shall exceed 12 months. All Payments are due by the 10th of
each calendar month (unless you specify an alternate date above). Payments
not received at "INNOMARKS, INC." within 5 days of the due date
will be considered late and will be charged a $15.00 late fee. Interest
Rates are charged on the "Balance Due" at a rate of 1.5%.
By Submitting this Credit Application "YOU" agree to the terms
contained herein, and if Approved this Application becomes a legal contact
between "YOU" and "INNOMARKS, INC". And "YOU"
agree to be bound by the terms and conditions within. "YOU" further
agree that in the event that legal proceedings are needed to enforce this
contract "YOU" will in addition to the "Balance Due"
be obligated to payment of "Late Fees" and incurred "Court
and Legal Counsel fees".
I enter this Credit Application
on the "Date of Application" entered above contained herein. And
I authorize "INNOMARKS,INC" or its assigns to investagate my
Credit which may include but not limited to the use of a "Credit Reporting
Agency". By entering my initials and submitting this form I agree to
all terms herein.
*Initial
here
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