Burhill Financial

 

Burhill Financial Services Personal Credit Application

PRIMARY APPLICANT


yrs.

yrs.



CO-APPLICANT


yrs.

yrs.


* Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

I/we certifiy that each of the statements made and answers given in this credit application is true and correct and is made for the purpose of inducing the financing/leasing of a vehicle or equipment.

I/we authorize the obtaining of a consumer report to be used in evaluating this application and the obtaining and exchanging of credit information from and with other creditors and consumer reporting agencies.

THE OHIO LAWS AGAINST DISCRIMINATION REQUIRE THAT ALL CREDITORS MAKE CREDIT EQUALLY AVAILABLE TO ALL CREDIT WORTHY CUSTOMERS AND THAT CREDIT REPORTING AGENCIES MAINTAIN SEPARATE CREDIT HISTORIES ON EACH INDIVIDUAL UPON REQUEST. THE OHIO CIVIL RIGHTS COMMISSION ADMINISTERS COMPLIANCE WITH THIS LAW.

I AUTHORIZE PROSPECTIVE CREDITORS TO ASK MY PAST AND CURRENT CREDITORS ("CREDIT REFERENCES"), INCLUDING CREDITORS LISTED ABOVE OR ON MY CREDIT REPORT ABOUT MY CREDIT PERFORMANCE WITH THEM. PROVISION BY PROSPECTIVE CREDITORS OF A COPY OF THIS AUTHROIZATION SHALL SERVE AS MY DIRECTION THAT MY CREDIT REFERENCES PROVIDE MY CREDIT PERFORMANCE INFORMATION.

Click here if you would prefer to download this application and fax or mail it to our office.


Burhill Financial Services | 116 N. Jefferson St.| Dayton, OH 45402 | Ph: (937) 224-3033 | Fax: (937) 224-8780 | Toll Free: (866) 521-0083