Request for Credit Info on New Account

Dear

Enclosed is a photocopy of Mr. Smith’s signed authorization for disclosure of credit information. Would you be kind enough to supply the information requested below. We have provided you with a copy of this request for your files.
Please return the original in the enclosed, postage paid envelope.

Name of Applicant: __________________________________

Address: __________________________________

City, State, Zip: __________________________________

Length of time of Credit Account:

Highest Credit Extended:

Credit Limit:

Average Monthly Balance:

Balance Now Due:

Balance Past Due:

Normal Paying Habits:

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