Credit Application

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Bel/Co Real Property Services
Credit Application

Personal Information

Name: _________________________________   SSN: _______________   Birth Date: ____________

Hm Address: __________________________________________________  Lic#: _________________

(check one)    Own: ____    Rent: ____   How Long: _________  Home Ph.#: _____________________

(if renting)   Lessor: ______________________________________  Ph#: _______________________

Previous Address: _____________________________________________________________________

Spouse: _________________________  SSN: ___________________  Lic#: _____________________

Savings Branch: ________________________  Acct#: __________________  Ph#: _______________

Checking Branch: _______________________  Acct#: __________________  Ph#: _______________


Business Information

Business Name: _____________________________________________  How Long: _______________

Business Description: __________________________________________________________________

Type of Business: (check one)  Corporation _____     Partnership _____     Sole Proprietor _____

Savings Branch: ________________________  Acct#: __________________  Ph#: _______________

Checking Branch: _______________________  Acct#: __________________  Ph#: _______________

Current Lessor: __________________________________________________  Ph#: _______________

Reason for Leaving: ___________________________________________________________________


Business Credit Reference

Name: ____________________________  Type: ______________________  Ph#: _______________

Name: ____________________________  Type: ______________________  Ph#: _______________

Name: ____________________________  Type: ______________________  Ph#: _______________
I/WE hereby authorize the property owner and /or  their property manager to verify any information provided herein by contacting
the sources listed or any other sources available. I/WE authorize the release of personal or credit information by any credit reporting
service. I/WE certify the information provided above is true and release the property owner and their property manager, officers,
agents and employees from any liability as a result of the use of this information or credit reports.

Dated: _________________                        BY: ___________________________________________


                                                                  BY: ___________________________________________