Fill in all applicable boxes below to submit pre-qualifying form. Your form will be forwarded to your nearest Latham dealer for review. You may be contacted by phone by a Latham Group representative for further information as needed. Your Latham dealer will notify you with the information by phone, mail and/or email, as soon as they become available.
PERSONAL INFO First Name Middle Initial Last Name SS# Date of Birth Marital Status # Dependents Current Address City/State/Zip Phone Number How Long at Current Address? Monthly Payment Current Status Previous Address City/State/Zip How Long at Previous Address Nearest Relative Relationship City/State/Zip
APPLICANT
--
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 ,2005
Single Married Separated
None 1 2 3 4 5 6 More
Years Months
$ Home Owner Renter Live with relative Other Years Months
CO-APPLICANT
EMPLOYMENT Employer City/State Phone
Job Title Hire Date Gross Salary
Previous Employer City/State Phone
Employed From
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec $ per week per year
to
Please enter your email address below:
MAINE: Consumer credit reports may be obtained in connection with this application. If you request, (1) you will be informed whether or not consumer reports were obtained; and (2) if reports were obtained you will be informed of the names and addresses of the consumer reporting agencies (credit bureaus) that furnished the reports. (Public Law Chapter 453 (1991)). NEW YORK: The creditor may obtain a consumer report on you in connection with your Credit Application. Upon request by you, the creditor will tell you whether or not a consumer report was obtained and the name and address of the consumer reporting agency that furnished the report.
I HEREBY DECLARE THAT ALL OF THE STATEMENTS MADE IN THIS FORM ARE TRUE AND CORRECT AND ARE MADE FOR THE PURPOSE OF OBTAINING CREDIT. THE CREDITOR IS AUTHORIZED TO INVESTIGATE MY CREDIT RECORD, TO VERIFY MY CREDIT, EMPLOYMENT AND INCOME REFERENCES, TO OBTAIN SUCH INFORMATION AS THE CREDITOR DEEMS NECESSARY, AND TO GIVE CREDIT REPORTING AGENCIES (CREDIT BUREAUS) AND OTHERS INFORMATION REGARDING THE CREDITOR'S CREDIT EXPERIENCE WITH ME.