Griff’s Furniture Emporium
Finance Request
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you lived at this residence?
Years/months
Employer
*
Company and supervisor’s name
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer phone number
*
How long have you had the job?
*
Facebook account name
Instagram account name
If military, rank and unit
3 personal references with cell
*
Name and cell number
Cost of furniture to be financed
Day of the month your like payment to come out.
1st
15th
Other (please explain at the bottom)
Down payment amount request
Half the total cost of furniture
Number of months requesting to pay off the remainder
1 month
2 months
3 months
4 months
Any additional information you would like to add or clarify:
Signature
Submit
Should be Empty: