Tombstone Indian Credit Application

Please read the following before completing this form: (1) Application represents that the information given in this application is complete and accurate and authorizes us to check with credit agencies, credit references and other sources disclosed herein investigating the information given. (2) Please read the attached agreement and sign below submitting your application.
Year:
Make:
Model:
Item #:
Down Payment:
How did you Hear of Us:
First Name:
Middle Initial:
Last Name:
Sr., Jr., III:
Present Address:
Apt #:
City:
State:
Zip Code:
Social Security Number:
Living Status:
Years at Residence:
Monthly Rent or Mortgage:	payment
# of Dependents:
Birth Date:
Home Phone:
Business Phone:
Employer:
Years at Job:
Total Annual Income:
Previous Employment Years:	(if less than 2 yrs. on current job)
Email Address:
Nearest Relative not Living with You:
Name:
Address:
City:
State:
Zip Code:
Home Phone:
Applicant Signature:		initials:
By typing your name and initialing in the box above you consent to a credit check.
Only click submit once please!