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Credit Application


[asterisks indicate required fields]

Applicant

*First Name:
Middle Initial:
*Last Name:
*Mailing Address:
*City:
*State:
*ZIP
*Home
*Desired Monthly Payment:
*Social Security Number:
*Date of Birth:
*Phone:
*Work Phone:
*Employer:
*How Long Employed by this Employer:
*Gross Annual Income (in Dollars):
*Closest Relative not Living with You:
*Relationship to You:

Joint Applicant

First Name:
Middle Initial:
Last Name:
Mailing Address:
City:
State:
ZIP
Home
Desired Monthly Payment:
Social Security Number:
Date of Birth:
Phone:
Work Phone:
Employer:
How Long Employed by this Employer:
Gross Annual Income (in Dollars):
Closest Relative not Living with You:
Relationship to You:

*Applicant Signature (type full name):
Joint Applicant Signature (type full name):



 

 


 

 

 
3905 SE 82nd Ave Portland, OR - (503) 258-9339 | 6850 SE 82nd Ave Portland OR - (503) 771 1111