Application for Credit

This is an application for credit with Stay Dry Ohio, LLC. You understand there is no agreement between us until we approve your credit application and accept all other required documents for funding.

Please Print Clearly and Complete All Requested Information.

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Applicant Information

First Name
Please enter your first name
Last Name
Please enter your last name
DOB
Please enter your date of birth
SSN
Please enter your SSN
Drivers' Lic. #/State
Please enter your driver license #/State
Home Address/City/State/Zip
Please enter your address/city/state/zip
Home Phone
Please enter a phone number
Cell Phone
Please enter a phone number

Please select at least one check box
How Long at Current Address?
Years
Please enter a number
Mos.
Please enter a number
Mortgage or Rent Pmt.
Please enter a number
Email Address
Please enter an email address
Current Employer
Please enter your current employer name
How Long?
Please enter a number
Position
Please enter your current position
Employer Phone
Please enter employer's phone number
Gross Mo. Income
Please enter your gross month income

Co-Applicant Information

First Name
Please enter co-applicant first name
Last Name
Please enter co-applicant last name
DOB
Please enter co-applicant date of birth
SSN
Please enter co-applicant SSN
Drivers' Lic. #/State
Please enter co-applicant driver license #/State
Home Address/City/State/Zip
Please enter co-applicant address/city/state/zip
Home Phone
Please enter a phone number
Cell Phone
Please enter a phone number

Please select at least one check box
How Long at Current Address?
Years
Please enter a number
Mos.
Please enter a number
Mortgage or Rent Pmt.
Please enter a number
Email Address
Please enter an email address
Current Employer
Please enter co-applicant current employer name
How Long?
Please enter a number
Position
Please enter co-applicant current position
Employer Phone
Please enter co-applicant employer's phone number
Gross Mo. Income
Please enter co-applicant gross month income
Other Income (Alimony, child support or separate maintenance income need not be revealed if you do not wish to have in considered as a basis for repaying this obligation)
Source
Please enter other income source
Amount
Please enter a number

Personal References (not in same household)

Name Please enter a name
Phone Please enter a phone number
Relationship Please enter relationship

Name Please enter a name
Phone Please enter a phone number
Relationship Please enter relationship

Optional Ach (Automatic Withdrawals)

I(we) hereby authorize lender or any assignee to initiate debit entries to the below-listed account for my monthly payments. This authorization remains in full force and effect until the lender/assignee has received written notification from me(us) in such time and such manner as to afford lender/assignee a reasonable opportunity to act on it. Please allow 10 days for all changes to be effective.
Bank Name Please enter a bank name
City/State Please enter a city/state
Invalid Input
Routing # Please enter a number
Acct # Please enter a number
**Please Attach a Voided Check or Deposit Slip**
By signing this application you promise all information is true and complete. You intend the seller and/or assignee to rely upon this information in deciding whether or not to extend credit to you. You authorize a full investigation and release of your credit record and your employment history. You also authorize the seller and/or assignee to release information about credit experience with them. You consent to receiving autodialed or prerecorded message calls from us or those acting on our behalf at any mobile telephone number you provide to us.
CREDIT REPORT NOTICE: We may request a credit report for any legitimate purpose associated with your application for credit, extending credit, modifying the terms of your credit agreement, or collection on your account. On your request, we will inform you if such a report was ordered and will give you the name and address of the credit reporting agency that furnished the report.
ALABAMA AND NEBRASKA RESIDENTS: You must be 19 years old to apply for credit.
CALIFORNIA RESIDENTS: If married, you may apply for a separate account.
NEW YORK RESIDENTS: We may obtain your credit report and we will inform you, upon request, whether a report was obtained and, if so, the name and address of the consumer reporting agency.
OHIO RESIDENTS: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio civil rights commission administers compliance with this law.
VERMONT RESIDENTS: We may obtain your credit reports at any time, for any legitimate purpose associated with the account or the application or request for an account, including but not limited to reviewing, modifying, renewing and collecting on your account. On your request we will inform you if such a report was ordered. If so, we will give you the name and address of the consumer reporting agency furnishing the report.
WISCONSIN NOTICE TO MARRIED APPLICANTS: No provision of any marital property agreement, unilateral statement under Wis. Stats. §766.59, or court decisions under Wis. Stats. §766.70 adversely affects the interest of the creditor unless the creditor is furnished a copy of the decree, agreement, statement, or has actual knowledge of the adverse provision prior to the time credit is granted.

Applicant Signature
Please enter your first and last names
Date
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Co-Applicant Signature
Please enter co-applicant first and last names
Date
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Stay Dry Waterproofing, LLC

Columbus Office
20 S Third Street, Suite 210
Columbus, OH 43056
(614) 339-3434 Columbus Office
Marysville Office
24575 Patrick Brush Run Rd.
Marysville, OH 43040 Marysville Office
Lancaster Office
117 W Main St. suite 104
Lancaster Ohio 43130 Lancaster Office

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