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Preferred Customer Card
Instant approval up to $6500 - No Annual Fee - No Hassle Credit - Easy Application
(Print and fill out the basic information, mail to us at 1000 S Saint Charles, Jasper IN 47542
or fax to 877-812-3386 or call 800-222-4303 for quick processing) - It will take literally a few minutes.
For detailed terms & current lending rates, write: GE Capitol Consumer Card Col, P.O. Box 276, Dayton OH 45401-0276, or call
800-333-1071
Name (Full) ___________________________________________________________________DOB________________
Current Address_____________________________________________________# of Dependants________________
City______________________________________________State___________________Zip_____________________
Home Phone____________________Salary (Annual)____________Email Address______________________________
Social Security No__________________________________Cell/Other Phone_________________________________
Housing Information (Please Circle Response)_____OWN_____________RENT_______________OTHER____________
Years at Residense_____________________Mortgage/Rent Payment_______________________________________
Employeers Name_______________________________________________Employeers Phone____________________
Years at Current Employeer (previous Employment time if less than 2yrs)____________________________________
Drivers License #________________________Issuing State___________Exp Date____________________________
Signature______________________________________________________________ Date_____________________
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