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Valley Tan , North Carolina

Home Tanning Bed Financing Application

Bed Model
Email
Applicant Information
First Name
Last Name
Initial
Home Address
Time at Residence
City
State
Zip
Date of Birth
Home Phone Number
Cell or alternate phone number (optional)
Social Security No.
- -
Business Telephone #
Employer
Total Gross Monthly Household Income
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis or repaying this obligation. Married Wisconsin Residents: Combine your and your spouse's information on this application.
Joint Applicant (optional)
Last Name
First Name
Initial
Relationship to Applicant
Home Address
Time at Residence
City
State
Zip
Gross Salary
Date of Birth
Social Security No.
- -
Employer
Employer Phone #


By submitting an application electronically for processing, I certify that I am at least 18 years of age (19 in AL or NE) and that everything I have stated above is true and accurate. If approved for credit, I agree to be bound by the terms of the Credit Agreement provided to me. I authorize my creditor (including for purposes of this paragraph any successor, assignee or representative of creditor) to investigate my creditworthiness and to obtain a credit report on me for any lawful purpose, including any update, extension of credit, review or collection of my account, and I specifically authorize the release of such information to creditor. If I request, my creditor will tell me whether any credit report was requested, and if so, the name and address of the consumer reporting agency furnishing the report. I expressly authorize creditor to contact me about my application and any credit extended, or for any other lawful purpose, including, without limitation, customer service or collection, at any address or telephone number that I may, from time to time, provide (including any cellular telephone number or ported landline), and expressly including, without limitation, calls made using automatic dialing and announcing devices that may play recorded messages.

I understand that, if approved, sellerís representative may be responsible for delivering to me my Credit Agreement that sets forth my credit repayment obligations and other applicable terms and conditions. I expressly authorize such deliveries. Married Wisconsin residents: I agree to provide a copy of my Credit Agreement to my spouse.




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