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Computer
System Financing
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No
Money Down
No
Application Fees
New
Desktop or Laptop Computers
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System You Are Applying For?
*
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Computer
Finance Application:
(Required
Fields are Bold)
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E-Mail Address * |
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First Name*
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Middle:
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Last Name
*
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Address * |
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City, St, Zip * |
,
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Years at Current
Address * |
Years Months |
| Previous
Address ( if less than 3 years ) |
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Previous Address |
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Previous City, St, Zip |
,
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Years at Previous Address |
Years |
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Home Phone * |
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Work Phone * |
Ext
or Dept |
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Own or Rent Your
Home? *
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Social Security
Number * |
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Date of Birth * |
MM/DD/YYYY |
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Marital Status * |
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| EMPLOYMENT INFORMATION |
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Employer Name * |
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Employer Address* |
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Employer City, St, Zip * |
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Years at Employer * |
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Net Monthly Income * |
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Position * |
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Spouse
Information
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If Married, Spouse
First Name
*
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Middle:
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Spouse Last Name
*
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Spouse SSN * |
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Date of Birth * |
MM/DD/YYYY |
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Is your Spouse Employed? * |
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Will your Spouse sign on Contract? * |
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Spouse Employer Name * |
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Spouse Employer Address * |
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Spouse Employer City, St, Zip * |
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Spouse Work Phone * |
Ext
or Dept |
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Spouse Net Monthly Income * |
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CREDIT
INFORMATION
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Declared Bankruptcy? * |
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Declaring Bankruptcy? * |
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Attend Credit Counseling? * |
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Have Credit Cards? * |
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Rent or Mortgage Per Month* |
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Utilities Per Month*
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Phone Bill Per Month*
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Credit Card Bills Per Month*
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List Current Obligations:
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Payments
Balance
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1.
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2.
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3.
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Total of All Bills*
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How would you rate your credit
history
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Where is your Pay Deposited:* |
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Is your pay on DIRECT DEPOSIT:* |
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How are you Paid? *
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How would you like to receive
your loan application*
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Fax Number |
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I HAVE READ, UNDERSTAND AND AUTHORIZE THE
FOLLOWING:
By
clicking the submit button, I hereby declare that I/We are applying for
an installment sales contract with Federal Credit Sales/Military
Financial Services, and/or their agents/associate companies. I
understand that the Federal Credit Sales/Military Financial Services,
and/or their agents, will order a copy of my credit history to verify
all information provided as well as contact my employer to verify
employment.
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