North Country Homes

North Country Homes
8515 E. M-115, Cadillac, MI 49601
Telephone: 1-231-775-1326
Fax: 1-231-775-9444
Email: info@northcountryhomes.org

 

CREDIT APPLICATION

I understand that by filling out this credit application I am subject to any and all laws pertaining to procurement of credit in the state of Michigan. By submitting this form I am attesting that any information I submit is both truthful and accurate to the best of my knowledge and I understand that I can be held either/both financially or criminally liable if found otherwise. I also authorize North Country Homes to utilize the information only for procurement of financing and none other. I understand that the information I am submitting will be held in the strictest of confidence and not shared or sold to any other agency with the exception of financing. This is a non-secure email form; if you are concerned about online security, please call us to receive an application.

Voluntary Information
APPLICANT:    I DECLINE TO FURNISH THIS INFORMATION APPLICANT GENDER
Caucasian Black Hispanic American Indian or Alaskan Native Asian or Pacific Islander Other Male Female
JOINT APPLICANT:     I DECLINE TO FURNISH THIS INFORMATION JOINT APPLICANT GENDER
Caucasian Black Hispanic American Indian or Alaskan Native Asian or Pacific Islander Other Male Female

Applicant

First Name

M.Initial

Last Name

Age

Email Address (Required)

Present Address

Social Security Number

City

State

Zip

How Long? yrs/mos.
Marital Status
Married
Unmarried
Separated

Home Phone (Required)
Do You
Own Rent Live with relative Other

Monthly Payment

Previous Address (If less than 2 years at present address)

No. Children

No. Children Under 12

City

State

Zip

How Long?

Name of nearest relative not living with you

Their Home Phone

Your Employer

City

State

Business Phone

Job Title

How Long yrs/mos
Are you
Employed Self Employed Retired Student Other

Gross Monthly Earnings

Additional Income
Source of additional income SSI/Retirement Disability Investment / Stock Rental Land Contract Other

Previous Employer

Job Title

How Long

Joint Applicant

First Name

M.Initial

Last Name

Age

Present Address

Social Security Number

City

State

Zip

How Long? yrs/mos.
Marital Status
Married
Unmarried
Separated

Home Phone
Do You
Own Rent Live with relative Other

Monthly Payment

Previous Address (If less than 2 years at present address)

No. Children

No. Children Under 12

City

State

Zip

How Long?

Name of nearest relative not living with you

Home Phone

Employer

City

State

Business Phone

Job Title

How Long yrs/mos
Are you
Employed Self Employed Retired Student Other

Gross Monthly Earnings

Additional Income
Source of additional income SSI/Retirement Disability Investment / Stock Rental Land Contract Other

Previous Employer

Job Title

How Long


   

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