Jewelry Accents

APPLICATION AND INITIAL CARDHOLDER DISCLOSURE

A CREDIT SERVICE OF GE MONEY BANK
For WI residents if you are applying for individual credit or joint credit with someone who is not your spouse, combine your and your spouse's financial information on the application form.

your name:
middle:
lAST:
date of birth:
social security no.:
Mailing Adress:
City:
state:
Zip. Code:
Time at Adress:
Yrs. Mos.
your Address?
Contact Person? 		If the above adress is a p.o box, you must provide a street address for your self or a contact person
Mailing Adress:
City:
state:
Zip. Code:
Time at Adress:
Yrs. Mos.
Home Phone No.
Cell Phone No.
Relative Phone No.
Housing Information
parents/relative Own Rent Other 		Monthly Net Income From all Sources.
Employers Name:
Employers Phone No.
Time at Job:
Yrs. Mos.



your name:
middle:
lAST:
date of birth:
social security no.:
Mailing Adress:
City:
state:
Zip. Code:
Time at Adress:
Yrs. Mos.
your Address?
Contact Person? 		If the above adress is a p.o box, you must provide a street address for your self or a contact person
Mailing Adress:
City:
state:
Zip. Code:
Time at Adress:
Yrs. Mos.
Home Phone No.
Cell Phone No.
Relative Phone No.
Housing Information
parents/relative Own Rent Other 		Monthly Net Income From all Sources.
Employers Name:
Employers Phone No.
Time at Job:
Yrs. Mos.




Please let us know of any comments that you might have.





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