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CREDIT APPLICATION

Please Complete Every Field - Enter NA if Not Applicable

CREDIT APPLICATION

First Name *

Last Name *

Phone *

Email *

Street Address *

City *

State *

Postal code *

Time at Address *

Date of birth *

MARITAL STATUS *

RENT OWN LEASE *

RENT

OWN

SOCIAL SECURITY NUMBER *

EMPLOYMENT

CURRENT EMPLOYER *

JOB DESCRIPTION *

HOW LONG AT CURRENT JOB *

ANNUAL INCOME *

PREVIOUS EMPLOYER *

PREVIOUS JOB ANNUAL INCOME *

ASSETS & LIABILITES

CHECKING & SAVINGS COMBINED *

401K BALANCE *

OTHER PROPERTY OWNED *

OTHER RETIREMENT BALANCE *

CHILD SUPPORT/ALIMONY PAYMENTS *

You understand that by clicking on the I agree button immediately following this notice,you are providing written instructions to Five Star Home Sales under the fair Credit Reporting Act authorizing Five Star Home Sales to obtain information from your personal credit report other information from experian. You authorize Five Star Home Sales to obtain such information solely to conduct a prequalification for credit.

Signature *

DATE *

35 Faith Mountain Rd.
Mount Vernon, KY 40456

(606) 392-2096

35 Faith Mountain Rd, Mt Vernon, KY 40456, USA

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