Online Residential Credit Application

required field

Loan Information

Amount (dollars):

Term (months):

Type:

Consumer Amounts: $1,500 to $20,000
Commercial Amounts: $2,500 to $50,000
Amounts less than $2,500 are subject to a $35.00 processing fee.


Dealer Information

 Dealer Name:
Dealer Phone Number:
Salesperson:


Information Regarding Homeowner

 Title: Mr.    Mrs.    Ms.    Miss   
 Name:
 Address:
 Years @ Address:
Previous Address:
Years @ Address:
 Home Phone:
 Social Security #:
 Date of Birth:



 Employer:
 Employer Address:
 Employer Phone: ext.
 Position:
 Salary (dollars):   per:
 Employment Length:   years
Additional Income Source:   $
 Bank Accounts:
 Mortgage payment:   $
 Marital status:
 Number of Dependents:



 Nearest Relative (other than spouse):
 Relative Address:
 Relative Phone:
 Relationship:


Information Regarding Co-Homeowner (if applicable)

Title: Mr.    Mrs.    Ms.    Miss   
Name:
Address:
Home Phone:
Social Security #:
Date of Birth:
Relationship to the Homeowner:



Employer:
Employer Phone:
Salary (dollars):  per:
Employment Length:   years
Additional Income Source:   $
Bank Accounts:
Mortgage payment:   $
Marital status:
Number of Dependents:



Nearest Relative (other than spouse):
Relative Address:
Relative Phone:
Relationship:

By clicking the Submit Form buttion, I/We certify that the information furnished on this application is true to the best of my/our knowledge and belief. Authorization is hereby given to Comfort Financial and/or any related business entity to contact recognized credit bureaus in order to secure credit information they may have pertaining to my/our credit paying habits, and further, to verify information furnished on this application.

Please print this page before submitting. In the unlikely event that an error occurs, you can fax or mail the form to us instead of filling it out in its entirety again.



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