Get Okinus

I understand that this application is subject to approval by Okinus at its offices in the State of Georgia and that all payments are remitted to its offices in Georgia. Signed Date 1. I get paid once a month on the th. I get paid another way. Explain BANK NAME Only Bank Checking accounts are accepted. Date Account Was Opened Routing Account Personal Reference Information References must be living at separate addresses Name 2 relatives and 2 friends Not living with Applicant City/State Home Phone with Area Code Relationship I hereby authorize Okinus to request information from my creditors employers and landlord and that my creditors employers and landlord should release such requested information. I certify that the information provided herein is true and correct. Retailer Name Phone Fax Cash price without tax Delivery Charge No Credit Check Program Salesperson This application must be completed in full before it can be processed* No boxes can be left blank. I am the applicant co-signer How are you related to applicant Mr. / Ms. Birth Mth Day If co-signer who are you signing with They are my Spouse Fiance First Name Year other Last Name Social Security Number MI Email Address Jr/Sr We email payment receipts. Present Home Address apt Home phone number Mtg Co/Landlord City Cellphone number Mth rent/Mtg pymt Mnth-Yr moved in buying renting Military must be E6 rank Mthly Gross Pay If live with write name of person and relationship Own LiveWith Hired Mth-Yr St* Occupation/Position Month and Day of Next Payday date Zip County you live in Home status is New Address if moving to Different location Present Employer Employer phone Your direct line and extension at work if applicable Ext My payday is circle one Mon Tues Wed Thur Fri Sat I get paid cirlce one Every week Every other week I get paid twice a month on the th and the th. Most recent paystub must have YTD Info Please fax to 1-229-294-0441 1-800-472-1334 2. Most recent personal checking account statement showing all transactions for 30 day period and summary page 3. Invoice if the customer has picked out what they want. Please list in detail the items and the purchase price. 4. Valid Government Issued Picture ID 5. Voided Check from the personal checking account provided or if no checks Authorization to Verify Account form* Proof of residency may be required in certain circumstances If current or previous customer self employed or Military call for different requirements rev* 12. Retailer Name Phone Fax Cash price without tax Delivery Charge No Credit Check Program Salesperson This application must be completed in full before it can be processed* No boxes can be left blank. I am the applicant co-signer How are you related to applicant Mr. / Ms. Birth Mth Day If co-signer who are you signing with They are my Spouse Fiance First Name Year other Last Name Social Security Number MI Email Address Jr/Sr We email payment receipts. I am the applicant co-signer How are you related to applicant Mr. / Ms. Birth Mth Day If co-signer who are you signing with They are my Spouse Fiance First Name Year other Last Name Social Security Number MI Email Address Jr/Sr We email payment receipts. Present Home Address apt Home phone number Mtg Co/Landlord City Cellphone number Mth rent/Mtg pymt Mnth-Yr moved in buying renting Military must be E6 rank Mthly Gross Pay If live with write name of person and relationship Own LiveWith Hired Mth-Yr St* Occupation/Position Month and Day of Next Payday date Zip County you live in Home status is New Address if moving to Different location Present Employer Employer phone Your direct line and extension at work if applicable Ext My payday is circle one Mon Tues Wed Thur Fri Sat I get paid cirlce one Every week Every other week I get paid twice a month on the th and the th.