PERSONAL CREDIT APPLICATION
NAME (Last, First, MI): _____________________________________________________________ SPACE #: ____________________________________
CURRENT ADDRESS: _____________________________________________________________ WORK PHONE: ______________________________
CITY, STATE, ZIP: __________________________________________________________________ HOME PHONE: _____________________________
SSN: ________ - ________ - __________ DATE OF BIRTH: ________ / ________ / _________ CELL PHONE: ________________________________
EMAIL ADDRESS: __________________________________________________________________ U.S. CITIZEN? [ ] YES [ ] NO
OWN: ______________ RENT: _______________ MONTHLY PAYMENT: _______________________ HOW LONG? _____________________
PRIOR ADDRESS
STREET ADDRESS: _________________________________________________________________________________________________________________
CITY, STATE, ZIP: ___________________________________________________________________________________________________________________
HOW LONG? __________________________
EMPLOYMENT
EMPLOYER: _______________________________________________ ADDRESS: ___________________________________________________________
OCCUPATION: ____________________________ BUSINESS TYPE: ___________________________ PHONE:______________________________
CONTACT NAME TO VERIFY EMPLOYMENT: _________________________________________ PHONE:______________________________
LENGTH OF EMPLOYMENT: ___________________ MONTHLY GROSS SALARY: ______________________
SPOUSE /CO-SIGNER
NAME (Last, First, MI): __________________________________________________________ HOME PHONE: ______________________________
STREET ADDRESS: ______________________________________________________________ CELL PHONE: ________________________________
CITY, STATE, ZIP: _________________________________________________________________________________________________________________
SSN: _________ - __________ - __________ DATE OF BIRTH: _________ / _________ / __________ U.S. CITIZEN? [ ] YES [ ] NO
SPOUSE / CO-SIGNER EMPLOYMENT
EMPLOYER: __________________________________________ ADDRESS: ______________________________________________________________
OCCUPATION: ____________________________ BUSINESS TYPE: ___________________________ PHONE:____________________________

CONTACT NAME TO VERIFY EMPLOYMENT: _____________________________________ PHONE:________________________________
LENGTH OF EMPLOYMENT: ___________________ MONTHLY GROSS SALARY: ____________________
PERSONAL REFERENCES
NAME: _________________________________ ADDRESS: _________________________________________ PHONE: _________________________
NAME: _________________________________ ADDRESS: _________________________________________ PHONE: _________________________
CREDIT REFERENCES
BANK: ______________________________ PHONE: ________________________________ CHECKING ACCT: _____________________________
CREDIT CARD #: _______________________________________________ CCV # __________________ EXP DATE: __________________________
CREDIT CARD #: _______________________________________________ CCV # __________________ EXP DATE: __________________________
1. Everything I stated on this application is correct. I understand that you will retain this whether or not it’s approved.
2. You are authorized to check my credit and employment history, verify current employment and answer questions (at a future
date) with my credit.
3. In the event my account becomes past due, I specifically authorize you to charge all amounts due to any major credit cards I
have listed on my credit application.
4. I understand that my lease will not become effective until your approval of my credit.
SIGNATURE: ___________________________________________________________________________ DATE: ________________________
SPOUSE / CO-SIGNER: _______________________________________________________________ DATE: ________________________
PLEASE SEND THE COMPLETED APPLICATION TO PHILIP@SUMMITMOBILECOMMUNITY.COM OR FAX TO
818. 340. 0284