MEMBERSHIP CREDIT APPLICATION
  
     

                  Annual Fee:
 $3,000.00 Personal or $6,000.00 Businesses

                        (Instructions:  Print out, complete all sections entirely, and return by fax, email, or directmail to address below.)
                   
Referred By:

Applicant’s Name (First, M.I., Last)                                          Co-Applicant’s Name
 

 

 

Amount Requested:  ($10,000 - $500,000 +)
Type of Service Requested With Membership:




 

Note: If Applicant and Co-Applicant have separate credit.  A separate credit application should be prepared for the Co-Applicant.

 

Mailing Address – Street                                                     City                                                     State                                          Zip

 

 

Move-in Date (MM/YY)

Telephone No.

(          )

Telephone in Home

ٱYes    ٱNo    ٱNearby

Telephone in Name of            Applicant:  ٱYES or NO  ٱ

 Unlisted ٱ     Listed ٱ    

 

Previous Address (Last 3 Years)                                                                Years at Previous Address

 

Number of Dependents

(Not including Self)

 

Applicant’s Date of Birth

Applicant’s Soc. Sec. No.

Co-Applicant’s Date of Birth

Co-Applicant’s Soc. Sec. No.

 

 

Nearest Relative Not Living With Applicant                       Address City  State Zip Code

Relationship

 

 

Housing Status

ٱ Owns/Buying     ٱ Free

ٱ Rents     ٱ With Parents

Type of Housing   ٱ Apartment   ٱ Mobile Home

ٱ House   ٱ Condominium   ٱ Room   ٱ Other:_______________

Monthly Rent/Mortgage Payment

$

 

Landlord/Mortgage Holder                                                       Account No.

Telephone No.

Include Taxes, Insurance, Ground Rent, Condominium

Fees, Mobile Home Lot Rent, Etc. as Applicable

 

Landlord/Mortgage Holder Address

City

State

Zip

 

  Home Owner’s

   Only

Purchase Date

Purchase Price

Original Mortgage

Present Balance

Interest Rate

 

 

Present Value

Property in Name(s) Of

 

 

Other Real Estate Owned                                                                                   In the Name(s) Of

 

 

Applicant’s Employer                                                                     Address

Telephone No

(          )

 

Employment Date

Occupation

Gross Monthly Salary

 

 

Applicant’s Previous Employer (Last 3 Years)

Occupation

Length of Employment

 

Co-Applicant’s Employer                                                             Address

Telephone No.

(          )

 

Employment Date (MM/YY)

Occupation

Gross Monthly Salary

 

Co-Applicant’s Previous Employer (Last 3 Years)

Occupation

Length of Employment

 

Other Income                              ٱ     Monthly                                                                   

                                              ٱ               Yearly         

Source of Income

Note: Alimony, Child Support or Separate Maintenance Income need not be disclosed if you do not wish to have it considered as a basis for repaying this obligation.

Bank Name/Location – Checking               Checking Account No.  ٱ Regular         Bank Name/Location – Savings    
        Savings Account No.    ٱ
Reg. Savings    ٱ    Now          ٱ      IRA Keogh       ٱ  Other                                                                                          ٱ  Other

Open/Paid Creditors – List Open and Closed Accounts:  ▪ Bank Credit Cards             ▪ Finance Companies           ▪ Credit Unions

(Attach Second Sheet if Necessary)                               ▪ Bank Loans                       ▪ Department Stores             ▪ Others   

Creditor Name/Location

Type of Account/Collateral

Account No.

Monthly Pymt.

Balance

Automobile Financed With

Year/Make/Model

 

 

 

Bank Credit Card(s) – Name of Issuer

 

 

 

 

 

 

 

 

 

         
         
         
         
         

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Monthly Payment and Total Balances of Open Accounts:

 

 

Certification & Acceptance:
Applicant confirms that he/she is the person named on this Membership Application that is being submitted to Artistic! Capital Corporation with consideration of Applicant becoming an annual member to qualify at discounted rates for each credit enhancement and/or funding placement service offered by the agency.  Applicant understands that he/she shall remain an active member for as long as its annual membership fee is paid in full each year upon its anniversary date as billed by the agency.  Applicant understands that he/she may make an immediate request for funding placement services up to the pre-qualified amount as so designated by the agency at any time after this application has been submitted and annual member has been paid in full.  Applicant understands that as a Member he shall not be required to pay the agency's placement fees and/or application fees when funding requests are made at the required agency minimums of $895.00 per funding request up to $300,000 and $1,595 for requests over and above $301,000.  As an annual member, all funding requests for placement for each member shall be charged at $460.00 for requests up to $300,000 and $795.00 for any requests over and above $301,000 respectively.  Agency shall provide all registered members with the appropriate forms, applications and submittal documents require for processing any funding and/or credit related requests at the time of membership acceptance.  Applicant understands that he shall be charged a flat rate for any purchase of Aged/Shelf Corporations made through the agency and/or will be provided a 50% discount OFF the total amount quoted at any given time when registered as an active annual member of the agency.  Upon receipt of any approved funds, credit cards, lines of credit, business loans, working capital loans/lines, personal loans, personal lines of credit, bank wire transfers and/or all other financial related products or services that have been disbursed to members through the agency's lending network, each member shall be required to pay only 12.9% agency fee on backend when funds have been received and/or all other credit related disbursements whether by credit card, loan check, line of credit check, and/or all other funding assignments made by this agency on the behalf of its members.  At time of approval and/or receipt of funding resources by any lender, Applicant agrees that he/she shall pay 12.9% to Artistic! Capital Corporation when invoiced and billed directly for its funding placement services.  Applicant understands that he/she will have 24-48 hours from the date of notification, release and/or approval by directmail or telephone that he/she must return the agency fee of 12.9% for any amount up to $300,000 and 14.9% for any amount over and above $300,000 to agency when invoiced.  Applicant agrees that should he/she wish to cancel his association and membership with Artistic! Capital Corporation that he will immediately notify agency within thirty (30) business days before the renewal or anniversary date before billing services commence for a new year.  If billing has taken place and Applicant has not notified agency accordingly as outlined, Applicant agrees that he/she must remit his membership fee for the next ongoing year as invoiced or the agency will report the remaining and outstanding balance to all major credit reporting agencies as unpaid until the final balance owing has been paid accordingly.  Applicant's signature below confirms acceptance of these terms and conditions as he/she agrees to abide by the terms and conditions as they have been presented by agency.

        Applicant Signature:                                                                                         Date:

             

                                                                  

Return by fax with your Check payment made payable to:
ARTISTIC! CAPITAL CORP.

Or express, priority mail and/or overnight to:
ARTISTIC! CAPITAL CORP.
ATTN: MEMBERSHIP DEPT.
1940 DEER PARK AVE., STE. 254
DEER PARK, NY  11729-3328 

 

 

                               

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©2003-2004 Artistic! Capital Corp.; ALL RIGHTS RESERVED.