Furniture Plus Finance Application

First Name

Last Name

Email Address

Cell Number

Call Time

Alternate Number

Call Time

Street Address

P.O. Box

City

Settlement

Island

Date of Birth (MM/DD/YY)

YYYY

Gender

Passport #

National Insurance #

Drivers License #

Country of Citizenship

Structuring sensible
finance opportunities
so you can enjoy a
beautiful, balanced life

Home Status

Years at Current Address

Roundup or down from 6 months

Mortgage or Rent Amount ($)

Previous Address

If less than 2 years at current address

Marital Status

# Dependents

Are you a former customer of ours?

Yes

Employer

Employer Address

Employer Phone Number

Employer Email Address

Employment Type

Date Hired (MM/DD/YY)

YYYY

Occupation

Title

Gross Salary

Net Salary

Pay Period

How did you hear about our financing services?

If a sales associate directed you to fill out a finance application, please share the name of your sales associate:

Would you like to have your Credit Application considered based on monthly salary deductions? Your chances of approval rise significantly if you choose to have payments automatically deducted

Yes

Not Applicable

Would you like to add a Co-Applicant?

YES, I WOULD LIKE TO ADD A CO-APPLICANT

NO, I DON’T WANT TO ADD A CO-APPLICANT

Providing manageable
monthly payments
that work with
your budget

First Name

Last Name

Email Address

Cell Number

Call Time

Alternate Number

Call Time

Street Address

P.O. Box

City

Settlement

Island

Date of Birth (MM/DD/YY)

YYYY

Gender

Passport #

National Insurance #

Drivers License #

Country of Citizenship

Home Status

Years at Current Address

Roundup or down from 6 months

Mortgage or Rent Amount ($)

Previous Address

If less than 2 years at current address

Marital Status

# Dependents

Are you a former finance customer of ours?

Yes

With express financing
you know quickly what
you are qualified to
purchase

Employer

Employer Address

Employer Phone Number

Employer Email Address

Employment Type

Date Hired (MM/DD/YY)

YYYY

Occupation

Title

Gross Salary

Net Salary

Pay Period

Would you like to have your Co-Applicant Credit Application considered based on monthly salary deductions? Your chances of approval rise significantly if you choose to have payments automatically deducted from your salary.

Yes

Not Applicable

REFERENCE #1

First Name

Last Name

Relationship

Address

Email Address

Phone Number

Preferred Call Time

REFERENCE #2

First Name

Last Name

Relationship

Address

Email Address

Phone Number

Preferred Call Time

REFERENCE #3

First Name

Last Name

Relationship

Address

Email Address

Phone Number

Preferred Call Time

The One and Only
Locally Financed
Home Goods Solution