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3629 I-49 S. Service Rd.
Opelousas, LA 70570

Credit Application

Applicant Information

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Housing Information

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Employment Information

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Joint Applicant Information

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Joint Applicant Housing Information

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Joint Applicant Employment Information

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Please enter a valid Phone number: 123-456-7890
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Please enter a Address.
Please enter a City.
Please enter a postal code: 12345 or 12345-1234
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Trade-In Information

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State of Consent

By submitting this form, I/we hereby:

  1. Understand and agree that you and any lenders you work with may make credit inquiries and employment inquiries about me, may provide and exchange information about me with any source of credit information to which you may apply, and may disclose information about me with other financial institutions for purposes of fulfilling this credit request;
  2. Certify that all information I have provided on this Application or in connection with this Application is true, correct and complete, whether completed by me or by you at my direction. I understand that you and the lenders you work with will rely on the information in this credit application in making its decision. I also understand that making false statements in order to obtain credit may be a crime;
  3. Certify that I am a US resident;
  4. Agree that if credit is approved, the lender may obtain subsequent consumer reports in connection with reviewing the account, and taking collection action on the account, or for other legitimate purposes associated with the account;
  5. Provide my express written consent for you and/or the lender to contact me, in connection with my loan, at the cell phone number(s) and email address(s) provided.
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