AAA Wolff Tanning - Credit Application

Please enter the following credit information:
(do not enter punctuation including hypens -, periods . or apostrophes ' )
*Loan Term:(months)
*Loan Amount:$.00
*Loan Type:

*First Name:
*Last Name:
*SSN (No Dashes):
*DOB (mm/dd/yyyy): / /

*Street Number and Name:  
* Type of Residence:
Monthly mortgage / rent: $.00

*Home Phone: - -
*Work Phone: - -

*Employer name:
*Job Title:
*Length of Employment (years):
*Employer City:
*Employer State:
*Income (monthly): $.00
Additional Sources of Income: $.00

*Bank Reference:

Joint Applicant Information (optional)
First Name:
Last Name:
SSN (No Dashes):
DOB (mm/dd/yyyy): //
Employer Name:
Job Title:
Length of Employment (years):
Employer City:
Employer State:
Income (monthly): $.00
Additional Sources of Income: $ .00

By submitting this form, I/we hereby authorize AAA Wolff Tanning Equipment & Citizen's Finance Company, its designee, assigns or potential assigns to review his/her personal credit profile provided by national credit bureaus in considering this application and for the purpose of updating, renewing, extending additional credit or the collection of any late account. I/We hereby authorize our references to release all credit information and I/We represent and warrant that the information submitted herein is true, complete and accurate. A facsimile, electronic or other copy of this authorization shall be as valid as the original. I certify that I am at least 18 years of age.