Computer System Financing

Computer System Financing

No Money Down

No Application Fees

New Desktop or Laptop Computers

System You Are Applying For? *

Computer Finance Application:

(Required Fields are Bold)

E-Mail Address *

First Name*

Middle:

Last Name *

Address *

City, St, Zip *

Years at Current Address *

Years Months

Previous Address ( if less than 3 years )

Previous Address

Previous City, St, Zip

Years at Previous Address

Years

Home Phone *

Work Phone *

Ext or Dept

Own or Rent Your Home? *

Social Security Number *

Date of Birth *

MM/DD/YYYY

Marital Status *

EMPLOYMENT INFORMATION

Employer Name *

Employer Address*

Employer City, St, Zip *

Years at Employer *

Net Monthly Income *

Position *

Spouse Information

If Married, Spouse First Name *

Middle:

Spouse Last Name *

Spouse SSN *

Date of Birth *

MM/DD/YYYY

Is your Spouse Employed? *

Will your Spouse sign on Contract? *

Spouse Employer Name *

Spouse Employer Address *

Spouse Employer City, St, Zip *

Spouse Work Phone *

Ext or Dept

Spouse Net Monthly Income *

CREDIT INFORMATION

Declared Bankruptcy? *

Declaring Bankruptcy? *

Attend Credit Counseling? *

Have Credit Cards? *

Rent or Mortgage Per Month*

Utilities Per Month*

Phone Bill Per Month*

Credit Card Bills Per Month*

List Current Obligations:

Payments Balance

Total of All Bills*

How would you rate your credit history

Where is your Pay Deposited:*

Is your pay on DIRECT DEPOSIT:*

How are you Paid? *

How would you like to receive your loan application*

Fax Number

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.