ALL INFORMATION IS REQUIRED
APPLICANT INFORMATION
FIRST NAME MIDDLE LAST NAME
SOCIAL SECURITY # DATE OF BIRTH (mm/dd/yyyy)
       
   
ADDRESS ZIP CITY STATE
DO YOU RENT/OWN DRIVER LICENSE                   STATE
            
HOME PHONE #                      CELL PHONE #                       EMAIL
         
SOURCE OF PRIMARY INCOME (Must be verifiable)
EMPLOYER OR
EMPLOYER ZIP EMPLOYER CITY STATE EMPLOYER PHONE EXT
 
HIRE DATE (MM/DD/YYYY)
MONTHLY INCOME
               
Open the calendar popup.
HOW ARE YOU PAID?              IS YOUR PAYCHECK DIRECT DEPOSITED TO YOUR BANK ACCOUNT? LAST PAYDAY NEXT PAYDAY
       Yes No
Open the calendar popup.
Open the calendar popup.
BANK ACCOUNT INFORMATION (Must be verifiable)
ROUTING #
(Routing number is a NINE digit number located on the bottom left of check)
BANK NAME CHECKING ACCOUNT # DATE OPENED (approximately)
Open the calendar popup.
CO-APPLICANT INFORMATION
FIRST NAME MIDDLE LAST NAME
SOCIAL SECURITY # DATE OF BIRTH (mm/dd/yyyy)
       
Open the calendar popup.
   
ADDRESS ZIP CITY STATE
DO YOU RENT/OWN DRIVER LICENSE                   STATE
            
HOME PHONE #                      CELL PHONE #                       EMAIL
         
CO-APPLICANT SOURCE OF INCOME (Must be verifiable)
EMPLOYER OR
EMPLOYER ZIP EMPLOYER CITY STATE EMPLOYER PHONE EXT
 
HIRE DATE (MM/DD/YYYY)
MONTHLY INCOME
               
Open the calendar popup.
HOW ARE YOU PAID?              IS YOUR PAYCHECK DIRECT DEPOSITED TO YOUR BANK ACCOUNT? LAST PAYDAY NEXT PAYDAY
       Yes No
Open the calendar popup.
Open the calendar popup.
CO-APPLICANT BANK INFORMATION (Must match information on voided check and bank statement
ROUTING #
(Routing number is a NINE digit number located on the bottom left of check)
BANK NAME CHECKING ACCOUNT # DATE OPENED (approximately)
Open the calendar popup.
TWO RELATIVES NOT LIVING WITH YOU
NAME CITY, STATE RELATIONSHIP PHONE #
STORE SELECTION INFORMATION
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I understand by submitting this Credit Appication you are Giving Furniture King LLC Permission to Run a Credit Report on all Applicants and Do An employment Verification.