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New Customer Forms |
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We require a completed credit application to be on file for ALL customers.
Please complete this form and fax or mail it to us at (815) 561 - 8611.
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Personal Credit Application |
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Berger Novelties & Awards
405 Phyllis Ave.
Rochelle,
IL. 61068-2133
815-561-1221 Fax 815-561-8611 |
Mailing Address:
Berger Novelties & Awards
PO
Box 357
Malta, IL. 60150-0357 |
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Applicant Information |
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Name: |
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Date of birth: |
SSN: |
Phone: |
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Current address: |
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City: |
State: |
ZIP Code: |
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Own Rent (Please circle) |
Monthly payment or rent: |
How long? |
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Previous address: |
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City: |
State: |
ZIP Code: |
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Owned Rented (Please circle) |
Monthly payment or rent: |
How long? |
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Employment Information |
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Current employer: |
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Employer address: |
How long? |
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Phone: |
E-mail: |
Fax: |
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City: |
State: |
ZIP Code: |
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Position: |
Hourly Salary (Please circle) |
Annual income: |
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Previous employer: |
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Address: |
How long? |
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Phone: |
E-mail: |
Fax: |
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City: |
State: |
ZIP Code: |
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Position: |
Hourly Salary (Please circle) |
Annual income: |
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Name of a relative not residing with you: |
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Address: |
Phone: |
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City: |
State: |
ZIP Code: |
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Relationship: |
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Co-Applicant Information, if for a joint account |
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Name: |
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Date of birth: |
SSN: |
Phone: |
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Current address: |
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City: |
State: |
ZIP Code: |
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Own Rent (Please circle) |
Monthly payment or rent: |
How long? |
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Previous address: |
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City: |
State: |
ZIP Code: |
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Owned Rented (Please circle) |
Monthly payment or rent: |
How long? |
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Employment Information |
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Current employer: |
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Employer address: |
How long? |
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Phone: |
E-mail: |
Fax: |
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City: |
State: |
ZIP Code: |
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Position: |
Hourly Salary (Please circle) |
Annual income: |
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Previous employer: |
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Address: |
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Phone: |
E-mail: |
Fax: |
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City: |
State: |
ZIP Code: |
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Position: |
Hourly Salary (Please circle) |
Annual income: |
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Berger Novelties & Awards
INDIVIDUAL Credit Application
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Application Information Continued |
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Name of a relative not residing with you: |
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Address: |
Phone: |
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City: |
State: |
ZIP Code: |
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Relationship: |
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Banking |
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Name |
Account Type |
Account No. |
Balance |
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Credit Cards |
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Name |
Account no. |
Current balance |
Monthly payment |
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Mortgage Company |
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Account no.: |
Address: |
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Auto Loans |
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Auto loans |
Account no. |
Balance |
Monthly payment |
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Other Loans, Debts, or Obligations |
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Description |
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Amount |
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