Credit Application


Date
04/25/2017

Quick Links:
Applicant:
  Name
  SSN/Date of Birth
  Address and Telephone
  Previous Address
  Driver's License
  Employer
  Personal References
  Financial status

Co-Applicant:
  Name/Email/Telephone
  SSN/Date of Birth
  Driver's License
  Employer

Joint application:
Store location you'd like credit for:

* How did you hear about Quality Furniture and/or this site?







:
* What products are you interested in purchasing?
* What monthly payment amount are you looking for?
* How much down payment can you afford?
Top of page

Applicant's Information:



* Last NameMiddle Name* First NameSuffix (Jr, Sr...)
Top of page

SSN/Date of Birth
* SSN* Date of Birth
- -
Top of page

Address/telephone
* Street AddressApt/SuiteE-Mail Address
Apartment complex/Mobile home park name
* City* State* Zip CodeYears at
Address
Months at
Address
* Telephone
(may use . or - or neither)
Mobile Phone
(may use . or - or neither)
Top of page

Previous address
Previous address and Landlord, Apt. Name
(* required if less than 9 months at current address)
Previous Apt/Suite
Previous CityPrevious StatePrevious Zip
Top of page

Driver's License
Driver's LicenseState
Top of page

Employer
* EmployerYears
Employed
Months
Employed
Street AddressCityStateZip Code
* TelephoneExt.SupervisorSupervisor's Telephone
How are you paid?

(* Salary OR Income)
Monthly Salary
(* Salary OR Income)
Other Income
Position
$$
Top of page

Personal references
* Reference's name* Telephone* Relationship
* Reference's name* Telephone* Relationship
* Reference's name* Telephone* Relationship
* Reference's name* Telephone* Relationship
Top of page

Financial status
Are you now in the process of filing for bankruptcy?
Have you in the last 7 years filed for bankruptcy?
If so, when?* Describe your current credit situation
Top of page

Co-Applicant's Information:



* Last NameMiddle Name* First NameSuffix (Jr, Sr...)
E-Mail AddressTelephone
Top of page

SSN/Date of Birth
* SSN* Date of Birth
- -
Top of page

Driver's License
Driver's LicenseState
Top of page

Employer
EmployerYears
Employed
Months
Employed
Street AddressCityStateZip Code
TelephoneExt.SupervisorSupervisor's Telephone
How are you paid?

Monthly SalaryOther IncomePosition
$$
Top of page

How would you like to be contacted regarding this application?





Top of page


By clicking 'Apply', I authorize Quality Furniture and its assignee to make whatever inquiries it deems necessary in connection with this credit application and in the course of review or collection of any credit extended in reliance on this application. I further authorize any person, lending agency, or consumer reporting agency to complete and furnish to the creditor and its assignee any information that it may have or obtain, in response to such inquiries, and agree that such information, along with the application, shall remain the creditor's and asignee's property, whether or not credit is extended. All information stated in this application is declared to be a true representation of the facts and made for the purpose of obtaining the credit requested.