FARMERS HOME FURNITURE ON-LINE CREDIT APPLICATION

 

Fields with * are required.


Personal Info

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Your Home

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* years    * months


About Your Employment

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* years   * months


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Other Income

NOTE: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for paying this obligation.


Store Location

Which of our Farmers Home Furniture stores are you likely to visit?


Contact Preference

How do you prefer to be contacted regarding your credit application?



By submitting this application for credit, you are authorizing Farmers Home Furniture to obtain consumer credit report(s) and to verify the information herein. Please be sure that all the information stated is correct before submitting. A member of our Credit Department will contact you, by the preferred method you have selected above, regarding your credit approval or should additional information be required.

I understand that if my credit is approved I must provide proper identification to the appropriate retail store and will be required to sign a credit agreement upon purchase.

This data is for the sole purpose of determining your credit status and will be used within the Farmers Home Furniture organization only, and will be processed at the Store Location you selected above. Farmers Home Furniture protects your information during transmission to us through an encryption process developed specifically for this purpose.