• No annual fee
• Good nationwide
• No application fee
• Save time -
Sears, Roebuck and Co. Credit Account Application
Please indicate below name in which account is to be carried. Courtesy titles are optronal. Applicant, if married, may apply for a separate account.
want your btlhng ma:led)
Social Securl1y Number
Number ol Dependents
How tong at
0 Live with parents
Monthly Rent or
than 2 years at present address)
OccupatlOll (Former occupatlOll
(d less than 1 year with present employer}
MaJO< Credrt Cards (VISA, MasterCard, etc.)
Credrt Cards (Dept. Stores. etc.)
0 Yes 0 No
You Have A·
Name of Bank/Flnanc1al lnstrtutK>n
0 Savings Account
0 Money Market
Relative or Personal Reference Not Living Wrth You
others are authorized to buy on the account,
pnnt names here and state relat10nship:
(Take Home Pay)
MOTE: Ahmony, child support or separate maintenance mcome need not
wish to have
considered as a basis for paying this
Name ol Lender
DYes 0 No
Account No (OptlOllal)
Account No. (Optional)
Is This An Interest
Paying Or NOW Account?
THE INFORMATION BELOW IS REQUIRED IF (1) YOUR SPOUSE IS AN AUTHORIZED BUYEA, (2) YOU RESIDE IN A COMMUNITY 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.
Social Securl1y Number
(Take Home Pay)$
Iagree to pay Sears 1n accordance with the credit terms disclosed to me and
comply with all
terms ol the SearsCharge Agreement. Acopy ol the SearsCharge Agreement will be given to
me to keep when my applicahon is approved. Sears will retain a securitY interest where
permitted by law under the
Commercial Code on all merchandise charged to the
account. Sears is authorized to investigate my credit, empk:lyment, and income references
and to report to proper persons and credit bureaus my performance of the account. Finance
charges not in excess of those permitted by law will
charged on the outstanding balance
from month to month.
Yes. enroll me in the optional SearsCharge Credit Protection Plan from Allstate. I authorize Sears Roebuck and
to add the insurance charges to my SearsCharge Account
Statement each month as they come due (subject to aPPfoval). I HAVE READ AND AGREE TO THE TEAMS AND CONDITIONS ON THE BACK OF THIS FOAM Iam under age 66
AZ, NV, OK. and VA), gainfully employed and actively working at least 30 hours
Dloft ;. ft,,.
NC NH NY
t991 Sears, Roebuck and Co.
SEE OTHER SIDE FOR IMPORTANT CREDIT TEAMS.