Credit Application

Elite Financial Services, Inc.

This form is confidential and will be encrypted prior to being sent to our secure server. All fields with a * are required.

Personal

If paying child support, alimony or child care, list below in accounts outstanding.

If purchase is for services only, purchaser does not need to indicate marital status.

Co-Applicant

Present Address

Previous Address

Present Employment

Previous Employer

Co-Applicant Present Employment

Co-Applicant Previous Employer

Other Income

Alimony, child support or separate maintenance income need not be revealed if purchaser does not wish to have it considered as a basis for repaying this obligation.

Auto

Bank

Nearest Relative (Not Living With You)

Accounts Outstanding

List all open accounts including home equity, auto, credit union and employer loans.

Be sure to include the information requested for the previous accounts above, including Company, Security, Date, High Credit, Terms, Balance and DOLP. Take as much space as you need to enter all remaining accounts.

By sending this form, I certify that these statements are true and complete. I authorize Elite Financial Services to check the information on this application, verify my employment, check credit references with credit bureaus and direct calls, and give information about this account to those who may lawfully receive it.

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