Application Type

 

Personal Information


Name   

Address  

City  State  Zip 

Social Security # 

Birthday (MM/DD/YYYY) 

Email Address 

Phone Number 

Housing Type 

Housing Payment 

Preferred Sales Person 
 

Employment Information

Employer Name 

Employment Date (MM/DD/YYYY) 

If Military, Your ETS Date 

Monthly Gross Income 

Other Monthly Income (child support, disability, rental property, etc.) 

Position 

Work Phone Number 

If Military, Specify Rank 

BAH Amount 

 

Employment Information

I certify that everything I have stated in this application and on any attachments is correct. Ashley Furniture Home Store may keep this application whether or not it is approved. By signing below or whether signed electronically, I authorize Ashley Furniture Home Store and any financial institution in which your application may be assigned to, agents, and/or associated companies to check my credit and employment history and to answer questions others may ask about my credit record. By providing my email address, I consent to receive electronic information such as notices of credit decisions and solicitation.

I have read and understand the above terms and conditions. 


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