CREDIT APPLICATION  PAGE 2 0F 3
PRINT OR TYPE

MARRIED  [  ]                  SINGLE [  ]           

HAVE YOU EVER FILED BANKRUPTCY   YES [  ]      NO [  ]

IF SO WHAT YEAR________            DISCHARGED___________

DO YOU KNOW WHAT YOUR CREDIT SCORE   YES [  ]         NO [  ]

CREDIT SCORE___________  AS OF WHAT DATE__________


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PAGE 2 0F 3 SUBMITTED BY_________________________________   DATE_________
                                                           APPLICANT