Loan Application

Privacy Statement

*Items in RED are required to accurately process this application

Please tell us a little about yourself
First Name* MI Last Name*
Spouses First Name MI Spouses Last Name
Your Address (line one)*
Your Address (line two)
City* State* Zip Code*
Home Phone* Work/Other Phone Soc. Sec. # *
Email Address* Date of Birth*

 

Please tell us about your Job*
Company Name*     Self employed*  Yes  No Retired* Yes  No
Address
City, State & Zip Code
Phone                                            Fax
      

Your Annual Income*
Your Job Source
Retirement Source
Other Source
Other Source

You needn't reveal any income that you don't want to be considered for this loan.

About Your Home

This information is needed to help us determine the approximate amount of the loan required to install Central Air Conditioning in your home.
  
Do you* Own?  Rent?
Existing Central Air?* Unknown  Yes No   
Size of Home*  Square Feet (approx)*  Unknown
Do you have an Attic* Unknown Yes No  
Is it insulated?* Unknown Yes No  
Size of your electric service* Unknown 100 Amp 150 Amp 200 Amp
Electric Service Type* Unknown Fuses Circuit Breakers

Addition Information or Comments

 

 

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Privacy Statement

The information gathered here or anywhere on our site will be only be used by us for the purpose of getting you a loan for the installation of a central air conditioning system and any related items such as duct work, filters, electrical work, thermostat, timer, humidistat or any other item that may be required or requested by you to facilitate a complete air conditioning system. Be assured that this information will not be sold, shared or otherwise distributed for any other purpose not expressly mentioned herein.