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Se~rsCharge
gives
you
Buying
Power
•
No annual fee
•
Good nationwide
•
No application fee
Sears, Roebuck and Co. Credit Account Application
Please indicate
below
name in which account is to
be
carried.
Courtesy
titles are optional.
Applican~
ff
married, may
apply
for a separate account
OMr.
OMiss
OMrs.
OMs.
Address
(to
which
you
want
your billing mailed)
Apt.IIApt..
City
State
Zip
Code
City
State
Zip
Code
Home
Phone
Business
Phone
Social Security Number
Age
Number of Dependents
(excluding Applicant)
Are
you
a Unrted D Yes
States citizen?
D
No
H
no,
state
immigration status
Are you a
D Yes
permanent resident?
0
No
How
long at
present address?
Yrs.
Mos.
D
Own
D
Rent
D
Board
D Live
~
parents
Monthly Rent or
Mortgage Payments
$
Former Address
(H
less
than 2 years at present address)
How
long?
Occupa!Jon (Former occupation
d
retired)
Yrs
Mos.
Former Employer
(d
less
than
1
year
w~
present employer)
Source of
Other
Income
Major Credit Cards (VISA, MasterCard,
etc.)
Account Number
Monthly Payment
$
Other
Credrt Cards (Dept Stores, etc.)
Account Number
Monthly Payment
$
Do You Have A
Checking Account?
DYes DNo
Name of Bank/Financial Institution
Do You Have A:
Name
of Bank/Financial Institution
0
Savings
Account
0
co
0
Money
Markel
0 IRA
Relative or Personal Reference
Not
Living
W~
You
H
olhers
are authorized
to
buy
on
the
account,
print names here and state relationship:
Spouse information
Address
1.
Net Income
(Take Home Pay)
$
How
long?
OMonthly
OWeekly
Yrs
Mos
NOTE: Alimony, child support or separate maintenance income need
not
be
revealed
d
you
do
not
wish to have
rt
considered as a basis for paying this obhgatoo.
Auto Loan?
Name of Lender
OYes ONo
Previous Sears Account?
OYes ONo
Account No. (Optional)
Account No. (Optional)
City
2.
Account Number
State
Monthly Payment
$
Is This An Interest
Paying
Or
NOW Account?
DYes DNo
Relationship
THE INFORMATION BELOW IS REQUIRED IF (1) YOUR SPOUSE IS AN AUTHORIZED BUYER, (2) YOU RESIDE IN ACOMMUNITY PROPERTY STATE (AZ, CA, ID,
LA,
NV, NM, TX, WA,
WI), OR (3) YOU ARE RELYING ON THE INCOME OR ASSETS OF ANOTHER PERSON AS A SOURCE FOR PAYMENT.
Name
of
Spouse
Address
I
Age
Employer
Address
How
I
Occupation
I
Social Security Number
I
Net Income
0 Monthly
long?
Yrs.
Mos.
(Take Home Pay)
$
OWeekly
Iagree
to
pay Sears in accordance
w~
the
credrt terms disclosed
to
me and
to
comply~
all
terms of
the
SearsCharge Agreement A
copy
ofthe SearsCharge Agreement will be given to
me
to
keep
when
my
application
is approved.
Sears
will retain a security interest where
permitted
by
law under
the
Uniform Commercial
Code
on all merchandise charged
to
the
account. Sears
is
authorized to investigate my credit, employment, and income references
x
and
to
report to report
to
proper
persons
and credrt bureaus my performance of
the
account.
Finance charges
not
in excess of those permitted
by
law will be charged on
the
outstanding
balance from
month
IO
month.
Applicant's Signature
Date
• 1989
Sears,
Roebuck
and
Co.
SEE OTHER SIDE FOR IMPORTANT CREDIT TERMS
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