SAMPLE CREDIT QUESTIONNAIRE Creditability and Reputation_________________________________ How long have you worked with him?___________________________ Highest credit on: Charge account___________________________ Highest credit on: Installment credit_______________________ Present amount owed: Due now________________________________ Present amount owed: Past due_______________________________ Meeting obligations promptly?________________________________ Present Address______________________________________________ Remarks______________________________________________________ Signed________________________ Date________________________ Length of time known?______________________ Age______________ Single or married__________________________ Character________________ Community Reputation_______________ Occupation______________ Employer's Name____________________ Employment steady?_______ Monthly Income (estimate)$_________ Amount owed you: Due now$_______________ Past due$__________ Meeting obligations promptly?________________________________ Present Address______________________________________________ Remarks______________________________________________________ Signed_______________________ Date________________________
