CREDIT APPLICATION

Submitted by ni7 on Fri, 12/07/2007 - 16:18.

* This information is for processing your credit application and contacting you, if necessary. It will not be sold or redistributed.

By submitting this information to us, you authorize NI7 to obtain your credit history from the major credit reporting agencies (Equifax, Experian, and Trans-Union).

NAME: *

(Last, First, Middle)

EMAIL ADDRESS: *

BIRTHDATE: *

(DD/MM/YYYY)

PHONE: *

DRIVERS LICENSE NO.: *

SOCIAL SECURITY NO.: *

NO. DEPENDANTS: *

AGE OF DEPENDANTS:

ADDRESS: *

(Street, City, State & Zip)

COUNTY: *

DO YOU OWN OR RENT & HOW LONG: *

PREVIOUS ADDRESS:

(Complete if less than 3 years at present address)

DID YOU YOU OWN OR RENT & HOW LONG:

EMPLOYER: *

(Company Name & Address)

LEGNTH OF EMPLOYMENT: *

WORK PHONE:

POSITION OR TITLE:

GROSS SALARY PER MONTH: *

NET SALARY PER MONTH:

PREVIOUS EMPLOYER:

HOW LONG AT PREVIOUS EMPLOYER:

NAME & ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOU: *

(Name, Relationship, Phone)

SOURCES OF OTHER INCOME:

Please put amount of said income.

HOW DID YOU FIND OUT ABOUT NI7?:

MARITAL STATUS:

Complete only if: for joint or secured credit, or applicant resides in a community date or is relying on property located in such a state as a basis for repayment of the credit requested.

TYPE OF VEHICLE DESIRED:

Vehicle Description:

Please include: YEAR, MAKE, MODEL and any OPTIONS or CUSTOMIZATION you would like done to your vehicle.

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CREDIT APPLICATION