285 / 600
FOR SEARS REVOLVING CHARGE ACCOUNT
SEARS, ROEBUCK AND CO., KANSAS CITY, MO .:
In consideration of your selling merchandise to m e on Sears R evolving
CHARGE ACCOUNT, I agree to the following regarding all purchases
m a de by me or on m y Sears R evolving C HARGE ACCOUNT iden tificatio n:
1.
I ha ve the privilege of a 30-day cha rge a ccount, in which case I will
pay the full amo unt for a ll m ercha ndise purchased within 30 days
from the date of each billing statement.
2 .
If
I do not pa y t he full amount for all m erchandise purcha sed within
30 day s from the date of each billing statement, the following terms
shall be in effect;
(A ) I will pay the time sale price for each item purchased consisting of:
(1)
The cash sale price, a nd
(2)
An amo unt of time price differential computed at
l Y,
%
of
th e bala nce at the beginning of each mont hly billing period
on so much of such bala nce a s does not exceed $500.00, a nd
~ % of
the balance at t he beginning of each mont hly billing
period o n so much of such balance in excess of $500.00, u ntil
the full a mo unt of all purchases a nd time price di ffere ntia ls
thereon a re pa id in full.
(B ) I will pay for t he merch a ndise purcha sed in mo n thly installme nts
wh ich shall be computed according t o the following schedule:
If the unpaid
balance is:
$
.01
to
$
10.00
10.01
to
150.00
150.01
to
200.00
200.01
to
250.00
.i!S0.01
to
300.00
lhe scheduled
monthlypayment
will
be:
Balance
$10.00
15.00
20.00
;?5.0Q
If the unpaid
balance is:
~300.01
to
$350.00
350.01
to
400.00
400.01
to
450.00
~50.01
to
500.00
Over
~500.00
lhe scheduled
monthlypayment
will
be:
$30.00
35.00
40.00
45.00
1/ 10
of
account bat.
(PLEASE SIGN AGREEMENT ON CUSTOMER'S SIGNATURE LINE)
MR.
I will pay each monthly installment computed
according to the sch edule at left upon th e re–
ceipt of each stat eme nt .
If
I fail to pay a ny in–
stallment in full when due, at your o p tion t he
full bala nce sha ll become immed iately d ue .
(C ) Yo u are to send me a stateme nt each month
which will show the unpa id balance for mer–
chandise purchased , your time p rice d ifferential
computed on the balance at the begi nning of
ea ch monthly billing period , a nd th e a mo u nt of
the mont hly installme nt comin g due.
(D ) I have the right to pay in advance.
(Customer 's Signature )
N
Accepted ,
SEARS, ROEBUCK AND CO .
Print names of other members of family
authorized to buy on your account.
NAME
ti\\5s
(PLEASE PRI NT"°)--o("°F1'""R'""s=T""'N""A'"'M"°E=)------,(M=1o'"'o"'L""'E'""1'"'°N"°1T"'1'"'A
7
L,...)
-------(c-L
7
A~ST""'°N'"'A
7
M=E)
Duplicate identification will be issued.
ADDRESS_______ ___ _________________________
ZIP
CITY_________________ STATE______ __ COOE___ _____ 2-------- ----------
MARRIED 0
WIFE
0
S
PHONE NO.___ ___ _______AGE_______SINGLE
Q
WIDOWED 0
j)IVORCEO 0
FIRST NAME__________ _
NUMBER OF
HOW LONG AT
RENT O
MONTHLY RENT OR
OEPENOENTS_ _ _ _ _ _______PRESENT ADDRESS,__ _____ _
OWN O
BOARD 0
MORTGAGE PAYMENTS
$____
NAME OF
STREET
CITY
LANOLORO_______________AOORESS______________ _ ANO STATE_______________
FORMER ADDRESS (IF LESS THAN
HOW
2
YEARS AT PRESENT ADDRESS)
LONG --------------
STREET
CITY
EMPLOYER________________________ AODRESS ______________ ANOSTATE_ ______
SOCIAL
TIME CARD DR
MO.
0
HOW LONG___ __OCCUPATION_________SECURITY NO._________BAOGE NO. ____EARNINGS
$____
WKLY. 0
FORMER EMPLOYER
HOW
(IF LESS THAN l YR. WITH PRESENT EMPLOYER>'----------------------------- LONG_ _______
NAME OF
ADDRESS OF
WIFE"S
WIFE'S EMPLOYER____ ___________WIFE'S EMPLOYER-----------------WEEKLY INCOME$____
SAVINGS
0
NAME OF
CHECKING
0
YOUR BANK-----------------s"'T"°'R'"'E"'E=T'"'A'""o'"'o'"'R'"'E"'s"'s-------- -----,c'"'1"'TYC--,.A°'"'N"'o....,s"'T"A"'T"'E_____ LOAN ACC"T NO. 0
EXPLAIN OTHER INCOME, IFANY---------------------------------------------
PREVIOUS
0
YES
SEARS ACCOUNT
0
NO
AT WHAT
ACCOUNT
IS ACCOUNT
0 YES
DATE FINAL
SEARS STORE ----------NO. ---------PAID IN FULL 0 NO
PAYMENT MADE______
ACCOUNTS AT
l
OPEN
I
OTHE~;TORES
(NAME OF FIRM)
(STREET ADDRESS)
(CITY AND STATE)
(ACCOUNT NO.) CLOSED
BANK LOANS.
I
OPEN
I
FINANCE, ETC.
2 ------(-N_A_M_E_O_F_F_IR_M_)______c=s=r=R=E=ET=A-o=o=R=Es=s-)_____c=c-1r=Y-A-N-o-s=T-A=T=E)_____ (_A=cc=o-u_N_T_ N_O_.)_ CLOSEDj
RELATIVE OR
PERSONALREFERENC~------------(S=T=R=E=E=T-A-o'"'o'"'R'"'E=s=s-)
_____________ (C'"'1T=v-A-N=o""'s=T=A=T=E-)____________
286
I
Sears
I•
See
Charge Account Information on other side
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