Zurich Citizens News, 1980-09-04, Page 36.01
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tURNAME
INSURANCE NO
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FIRST NAME
INITIAL(S)
STATUS
AGE
SPOUSE S NAME
OTHER INCOME
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MISS
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OWN YOUR HOME? MORTGAGE HELD BY -
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DYES III NO ,
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'• MONTHLY PAYMENT
$
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'COMPANIES YOU VE DEALT WITH (other credit cards finance co s banks etc) -
1 ....
STARTING AMOUNT
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ADDRESS
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APT NO(
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AT THIS ADDRESS
, Yr mo •
HOME PHONE
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CITY TOWN
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PROV.
POSTAL CODE
NO. OF DEPENDENTS
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.-,,BUSINESS PHONE '-
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EMPLOYER'S NAME -
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YOUR SOCIAL
INSURANCE NO
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HOW LONG?. -
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PRESENT POSITION
ADDRESS ,
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SALARY
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PREVIOUS EMPLOYER . . .
• CITY TOWN
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' HOW LONG?
POSITION _
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PRESENT LOAN BAL
$
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OWN YOUR HOME? MORTGAGE HELD BY -
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DYES III NO ,
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MORTGAGE BAL
$
A'
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'• MONTHLY PAYMENT
$
-
'COMPANIES YOU VE DEALT WITH (other credit cards finance co s banks etc) -
1 ....
STARTING AMOUNT
$ .
PRESENT BALANCE
$ -
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2- - - ' -
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$ -
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YOUR BAN K. BRANCH, '
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CHECIUING ACCT .NO
SAVINGS ACCT NO
ADDRESS
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CREDIT CARD NO
PRESENT LOAN BAL
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DEALERSNAME.
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PREV ACCT WITH US
NO
DESIRED CR LIMIT,
$ '
The undersigned agree(s) that a persi investigation
may be conducted or a credit report ("Whined in respect of
this application. If accepted, I/we also agree to abide by
the terms of the Revolving Charge Account Agreement
("Cardholder's Agreement") which will accompany the
charge card(s). Use of the card(s) will be evidence that
I/we have received the Cardholder's Agreement.
This revolting credit plan is offered as a customer SIGNATURE
service by Conklin Home Centres, P.O. Box 2340, London,
Ontario N6A 4G3. The plan is a personal financial service
of Traders Group Limited.
DAY OF
IF MARRIED. SPOUSE'S SIGNATURE
PM RI LOOK
or several years you've known us es Dlieount
Dave's. In order to ovoid the oonfuelon with our
corporate mune, trent now on you'll know us as
CoMdln Home Centres. The name has changed
but the hiendly people, the greet servkWand
the good value remain.
CONKLIN
HOME
CENTRES
=rat 1-1
theiacrail2s.
dI• 110211,601.
Wools, aisaellein.
farossl=o
MOM
INAtiiub.
ostesrovor
6
KINGSVILLE 733-2341
HARROW 738-2221
AMHERSTBURG 730-2151
WINDSOR WEST 734-1221
WINDSOR CENTRE 254-.1143
WINDSOR EAST 727-6001
RI DG ETOWN 674-5465
WEST LORNE 768-1520
EXETER • • - 235-1422
238-2374
296-4911
- 524-8321
KINCAFtDINE.... . 396-3403
SOUTHAMPTON ...... . . 797-3245
OWEN SOUND 376.3181
KITCHENER • 893-7901
KItohooir Out-of-tova• CU Free of Citaro.1400-2064204
GRAND BEND ...
THEDFORD •
GODERICH '
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