APPLICANT: Please read the following before completing this form: (1) Applicant represents that the
information given in this Application is complete and accurate and authorizes us to check with credit
reporting agencies, credit references and other sources disclosed herein in investigating the information
given; (2) Applicant requests a Credit Card if it is our practice to provide one; (3) Married applicants
may apply for an individual account; (4) Applicant represents that this Account will only be used for
personal, family or household purposes; **(5) Sale Amount-this figure does not represent the amount of
credit applied for; it reflects purchase price of merchandise only.
YOU WILL NEED TO READ AND SIGN THE
AGREEMENT BEFORE SUBMITTING YOUR APPLICATION.