Over 60 years
of quality service
Credit Application
Name:
Social Security #:
Drivers License #:
Home State:
Years at Current Address:
Date of Birth:
Home Phone:
Current Address:
Current City:
Current State:
Current Zip
Rent or Own:
Nearest Relative/Relationship:
Relative Phone:
 
Employer:
Position:
Work Phone:
Income: /Mo
Other Income: /Mo
Source:
Employer Address:
Contact:
Years Employed:
 
Spouse Name:
Social Security #:
Date of Birth:
Work Phone:
 
Spouse Employer:
Address:
Years Employed:
Position:
Contact:
Income:
Other Income:
Source:
 

By digitally signing below, you certify that all information given in this application is true and complete. You also authorize us to confirm the information in this application and give out information about you or your account to credit agencies and others who are allowed to receive it. You authorize and instruct us to request and receive credit information about you from any credit reporting agency or third party. Please be aware that if credit is extended and your account is referred to collections, you will be responsible for all collection costs, court costs and attorneys fees.
 
Applicant Signature:
Date:
Spouse Signature:
Date:
 
How can we reach you?   E-mail Address or Phone #
 

 

Monday through saturday 8am-6pm
Sunday 11am-5pm 		303 Spokane Ave.
Coeur D'alene, ID 83814 		Ph. 208-664-2131
Fax. 208-667-5038 		Runge Guarantee
Runge Furniture