CREDIT APPLICATION
Individual
Prepared by: Agent ____________________________
Broker ____________________________
Phone _______________________
Email _______________________
DATE: _____________, 20______, at_____________________________________________________, California.
THIS CREDIT APPLICATION is for the amount of $_______________.
Property address: ______________________________________________________________________________
Received from Applicant(s) $_______________,
cash, or
check, for a consumer credit report which is
a non-refundable cost and not a deposit.
Applicant(s):
Applicant One __________________________________________________________________________________
(Last Name)
(First Name)
(Middle Name)
(Sr., Jr., etc.)
Social Sec. # ________________________________ Drivers Lic. # ______________________ State______
Applicant Two __________________________________________________________________________________
(Last Name)
(First Name)
(Middle Name)
(Sr., Jr., etc.)
Social Sec. # ________________________________ Drivers Lic. # ______________________ State______
Additional Occupant(s): Name ___________________________________________________________________
Name ___________________________________________________________________
Rental History: Have you ever been party to an eviction?
Yes
No
Filed bankruptcy?
Yes
No
Present Address ________________________________________________________________________________
City ____________________________________________________________ Zip _______________________
Length of Residency _____________ Monthly Rent $_______________
Landlord/Agent ______________________________________________________________________________
Address ____________________________________________________________________________________
City ___________________________________ Zip ____________________ Phone _____________________
Reason for Moving _________________________________________________ Moving Date ____/____/____
Previous Address _______________________________________________________________________________
City ____________________________________________________________ Zip _______________________
Length of Residence _____________ Monthly Rent $_____________
Landlord/Agent ______________________________________________________________________________
Address ____________________________________________________________________________________
City ___________________________________ Zip ____________________ Phone _____________________
Employment:
Applicant One
Employer __________________________________________________________________________________
Address ___________________________________________________________________________________
City ___________________________________ Zip ____________________ Phone _____________________
Length of Employment _____________ Position ________________________________ Wages ___________
Pay Period ____________________ Union _______________________________________________________
Previous Employer ___________________________________________________________________________
Address ____________________________________________________________________________________
City ___________________________________ Zip ____________________ Phone _____________________
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Applicant Two
Employer ___________________________________________________________________________________
Address ____________________________________________________________________________________
City ___________________________________ Zip ________________________ Phone __________________
Length of Employment _____________ Position ___________________________ Wages _________________
Pay Period ____________________ Union ______________________________________________________
Previous Employer ___________________________________________________________________________
Address ____________________________________________________________________________________
City ___________________________________ Zip ________________________ Phone __________________
Additional Income Amount $_____________ Source __________________________________________________
Recipient ______________________________________________________________________________________
General Credit Information:
Automobile One: Make __________________________________________________________________________
Year _____________ Model ____________________ Lic. #/State ____________________________________
Lender _____________________________________________________________________________________
Automobile Two: Make ___________________________________________________________________________
Year _____________ Model ____________________ Lic. #/State ____________________________________
Lender _____________________________________________________________________________________
Bank/branch ___________________________________________________________________________________
Check Acc. # _______________________________________ Savings Acc. # __________________________
Bank/branch ___________________________________________________________________________________
Check Acc. # ______________________________________ Savings Acc. # __________________________
Credit References:
1. ________________________________________________________________________________________
Address ____________________________________________________________________________________
Account # ______________________________ Balance due $_______________ Phone __________________
2. ________________________________________________________________________________________
Address ____________________________________________________________________________________
Account # ______________________________ Balance due $_______________ Phone __________________
Personal Reference ________________________________________________________________________________________________
Address ___________________________________________________________ Phone _________________
Personal Reference ________________________________________________________________________________________________
Address ___________________________________________________________ Phone _________________
Nearest Relative (name/relationship) _______________________________________________________________________________
Address ___________________________________________________________ Phone _________________
I/We declare all information given in this application is true and correct. I/We authorize your credit reporting agency to
obtain and verify a complete consumer report and supply the information obtained to you.
This information is not privileged.
Date: _____________, 20______
Name: ____________________________________________
I acknowledge receipt of this credit application and
accompanying payment.
Seller or Lender: ____________________________________
Signature: __________________________________________
(Applicant 1)
Name: ____________________________________________
Signature: _________________________________________
Phone: ____________________________________________
Signature: __________________________________________
(Applicant 2)
FORM 302
03-11
© 2011 first tuesday, P.O. Box 20069, RIVERSIDE, CA 92516 (800) 794-0494