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Beaulieu of America Financing
Atlanta Flooring Resource & Design
A Division of Atlanta Carpet Services
We Accept all Major Credit Cards
*Full Name:
*Date of Birth:
*Social Security Number:
Home Phone:
*Street Address:
Mailing Address if Different:
Time at Address:
*Cell/Other Phone:
Housing Information:
Monthly Net Income From All Sources:
Time at Job:
Employers Phone Number:
Relative Phone Number:
E-Mail Address:
By providing an e-mail address I consent to receive e-mail communication about my Account and authorize you to provide my e-mail address to Beaulieu of America so that I may receive such communications, offers and updates.
1. APPLICANT INFORMATION: Tell us about yourself.
2. CO-APPLICANT INFORMATION (complete only if co-applicant will
receive a "Beaulieu of America Credit Card)
Full Name:
Date of Birth:
Social Security Number:
Home Phone:
Street Address:
Mailing Address if Different:
Time at Address:
Cell/Other Phone:
Housing Information:
Monthly Net Income From All Sources:
Time at Job:
Employers Phone Number:
E-Mail Address:
By providing an e-mail address I consent to receive e-mail communication about my Account and authorize you to provide my e-mail address to Beaulieu of America so that I may receive such communications, offers and updates.
I am providing the information in this application to GE Money Bank(GEMB), to Beaulieu of American, to dealers ("Dealers") that accept the Beaulieu of America Credit Card ("Card") and to program sponsors, and asking GEMB to issue me a Card. By applying for this account, I authorize and agree that:
3. APPLICANT AND CO-APPLICANT: We need your signature(s) below.
GEMB may furnish this and other information about me (even if my application is denied) and my account to Beaulieu of America and to Dealers and program sponsors (and their respective affiliates) to create and update their records, and to provide me with service and special offers.
GEMB may make inquiries it considers necessary (including requesting reports from consumer reporting agencies and other sources) in evaluating my application, and for purposes of reviewing, maintaining or collecting my account.
If my application is approved, the Beaulieu of American Card Agreement ("Agreement") will be sent to me and will govern my account.
Among other things, the Agreement: (1) INCLUDES AN ARBITRATION PROVISION THAT MAY LIMIT MY RIGHTS UNLESS I REJECT THAT PROVISION UNDER THE AGREEMENT'S INSTRUCTION; and (2) makes each applicant responsible for paying the entire amount of credit extended; and (3) grants GEMBa security interest in the goods purchased on the account as permitted by law.
I consent to GEMB and any other owner or service of my account contacting me about my account, including using any contact information or cell phone numbers I provide, and I consent to the use of any automatic telephone dialing system and/or an artificial or prerecorded voice when contacting me, even if I am charged for the call under my phone plan.
This application and the Agreement are governed by federal law and Utah law (to the extent that the state law applies).
Federal law requires us to obtain, verify and record information that identifies you when you open an account. We will use your name, address, date of birth, and other information for this purpose.
Please note that you must reside in the United States and be 18 years or older to apply.
*Signature:
Applicant's Name:
Title:
Co-Applicant's Name:
Title:
PLEASE READ AND KEEP THE GE MONEY BANK KEY CREDIT TERMS AND INITIAL CARDHOLDER DISCLOSURE STATEMENT BEFORE SIGNING THIS APPLICATION.
