Fillable CREDIT APPLICATION ll l months SECTION A - (Eastern Shawnee Tribe of Oklahoma)

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CREDIT APPLICATION ll l months SECTION A - (Eastern Shawnee Tribe of Oklahoma)

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U.S.A. forms for Eastern Shawnee Tribe of Oklahoma

BROWSE EASTERN SHAWNEE TRIBE OF OKLAHOMA (OK) FORMS

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CREDIT APPLICATION
SECTION A - INDIVIDUAL APPLICANT INFORMATION
SECTION B - JOINT APPLICANT OR OTHER PARTY INFORMATION
SECTION C - MARITAL STATUS
AMOUNT REQUESTED
$
FOR HOW LONG PAYMENT DATE DESIRED WANT TO REPAY
MONTHLY
PROCEEDS OF LOAN TO BE USED FOR:
DATE CLASS NO.
ACCOUNT NO.
APPROVED BY
DECLINED BY
FOR CREDITOR USE
SECURED INDIVIDUAL CREDIT - relying solely on my income or assets
UNSECURED INDIVIDUAL CREDIT - relying on my income or assets as well as income or assets from
JOINT CREDIT - We intend to apply for joint credit. (initials)
other sources
IMPORTANT: Check ( ) the appropriate boxes below and complete the applicable sections.
Complete only if: for joint credit, for individual credit relying on income or assets from other sources, or applicant is married and resides in a community property state.
NAME (Last, First, Middle)
BIRTHDATE
ADDRESS (Street, City, State & Zip)
PREVIOUS ADDRESS (Street, City, State & Zip) (Complete if less than 3 years at present address)
EMPLOYER (Company Name & Address)
BUSINESS PHONE Ext.
PREVIOUS EMPLOYER (Company Name & Address)
NAME AND ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOU RELATIONSHIP TELEPHONE NO. (Include Area Code)
SOURCES OF OTHER INCOME
Is any income listed in this Section likely to be reduced before the credit request is paid off?
TELEPHONE NO. DRIVER'S LICENSE NO. SOCIAL SECURITY NO. NO. DEPENDENTS AGES OF DEPENDENTS
COUNTY
COUNTY
HOW LONG
HOW LONG
HOW LONG
Do you own
or rent?
Did you own
or rent?
POSITION OR TITLE
SALARY PER MONTH
GROSS: $ NET: $
AMOUNT PER MONTH
$
Have you previously received credit from us?
No Yes - When?
AGES OF DEPENDENTSNO. DEPENDENTS
HOW LONG
HOW LONG
HOW LONG
HOW LONG
SOCIAL SECURITY NO.DRIVER'S LICENSE NO.
PRESENT ADDRESS (Street, City, State & Zip)
POSITION OR TITLE
AMOUNT PER MONTH
$
NAME (Last, First, Middle)
BIRTHDATE
RELATIONSHIP TO APPLICANT (If Any)
EMPLOYER (Company Name & Address)
BUSINESS PHONE Ext.
PREVIOUS EMPLOYER (Company Name & Address)
SOURCES OF OTHER INCOME
Is any income listed in this Section likely to be reduced before the credit requested is paid off?
TELEPHONE NO.
Has Joint Applicant or Other Party ever received credit from us?
No Yes - When?
Complete only if: for joint or secured credit, or applicant resides in a community property state or is relying
on property located in such a state as a basis for repayment of the credit requested.
APPLICANT Married Separated Unmarried (including single, divorced, and widowed)
OTHER PARTY Married Separated Unmarried (including single, divorced, and widowed)
No Yes (Explain)
Alimony, child support, separate maintenance received under: Court Order Written Agreement Oral Understanding
No Yes (Explain)
Alimony, child support, separate maintenance received under: Court Order Written Agreement Oral Understanding
GROSS: $ NET: $
SALARY PER MONTH
Federal law requires financial institutions to obtain sufficient information to verify your identity. You may be asked several
questions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information. The
information you provide is protected by our privacy policy and federal law.
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TYPE OF CREDIT REQUESTED
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
IMPORTANT APPLICANT INFORMATION:
(page 1 of 2)
1986 Bankers Systems, Inc., St. Cloud, MN Form UCA 6/30/2003
-
months
SECTION D - ASSET & DEBT INFORMATION
SECTION E - SECURED CREDIT
If Section B has been completed, this Section should be completed giving information about both the Applicant and Joint Applicant or Other Person.
Please mark Applicant-related information with an "A". If Section B was not completed, only give information about the Applicant in this Section.
(Including charge accounts, installment contracts, credit cards, rent, mortgages and other obligations. Use separate sheet if necessary.)
CHECKING ACCOUNT NUMBER(S)
(where)
SAVINGS ACCOUNT NUMBER(S)
(where)
CERTIFICATE OF DEPOSIT(S)
(where)
MARKETABLE SECURITIES
(issuer, type, no. of shares)
REAL ESTATE
(location, date acquired)
LIFE INSURANCE
(issuer, face value)
AUTOMOBILES
(make, model, year)
OTHER
(list)
$
TOTAL ASSETS
$
(Use separate sheet if necessary.)
$
TOTAL DEBTS $$
(OMIT RENT) (OMIT RENT)
$$$
LANDLORD OR MORTGAGE HOLDER
AUTOMOBILES
(describe)
Rent Payment
Mortgage
Complete the following information about both the Applicant and Joint Applicant or Other Person (if applicable):
Are you obligated to make Alimony, Support or Maintenance Payments? No Yes
If yes, to (Name & Address) Amt. per month $
Are you a co-maker, endorser, or guarantor on any loan or contract? No Yes If yes, for whom? To whom?
Are there any unsatisfied judgments against you? No Yes If yes, to whom owed? Amount $
Have you been declared bankrupt in the last 10 years? No Yes If yes, where? Year?
Complete only if credit is to be secured. Briefly describe the property to be given as security:
PROPERTY DESCRIPTION
NAMES & ADDRESSES OF ALL CO-OWNERS OF THE PROPERTY
IF THE SECURITY IS REAL ESTATE, GIVE THE FULL NAME OF YOUR SPOUSE (if any).
I certify that everything I have stated in this application and on any attachments is correct. Lender may keep this application whether or not it is
approved. By signing below I authorize Lender to check my credit and employment history and to answer questions others may ask Lender about my credit record with
Lender. I understand that I must update credit information at Lender's request if my financial condition changes.
Applicant's Signature Date Other Signature (Where Applicable) Date
OUTSTANDING DEBTS
DESCRIPTION OF ASSETS NAME IN WHICH THE ACCOUNT IS CARRIED VALUESUBJECT TO DEBT?
ASSETS OWNED
CREDITOR
NAME IN WHICH
THE ACCOUNT IS CARRIED
ACCOUNT
NUMBER
ORIGINAL
AMOUNT
MONTHLY
PAYMENTS
PRESENT
BALANCE
SIGNATURES-
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1986 Bankers Systems, Inc., St. Cloud, MN Form UCA 6/30/2003
-
(page 2 of 2)
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CREDIT APPLICATION ll l months SECTION A - (Eastern Shawnee Tribe of Oklahoma)

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Completed 20 July 2020

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