Phone: 937 435 0134

GUARDIAN FINANCE COMPANY
Date: Amount Financed:

Primary Applicant (APPLICANT A)
First Name: Middle Initial: Last Name: Date of Birth: Social Security #: E-Mail Address:
Street Address: City: State: Zip Code: How Long?: Home Phone:
Previous Address: City: State: Zip Code: How Long?: Cell Phone #:
Employer: Position: Gross Income: How Long?: Work Phone:
*Other Income: Source: Checking Institution: Savings Institution:
Type of ID: State of Issuance: ID#: Date of Issuance: Expiration Date:
Personal Reference Name, Address, and Phone Number:

Optional Co-applicant For Joint Accounts (APPLICANT B)
First Name: Middle Initial: Last Name: Date of Birth: Social Security #: E-Mail Address:
Street Address: City: State: Zip Code: How Long?: Home Phone:
Previous Address: City: State: Zip Code: How Long?: Cell Phone #:
Employer: Position: Gross Income: How Long?: Work Phone:
*Other Income: Source: Checking Institution: Savings Institution:
Type of ID: State of Issuance: ID#: Date of Issuance: Expiration Date:
Personal Reference Name, Address, and Phone Number:

The Ohio Law against discrimination requires that all creditors make credit equally available to all creditworthy customers and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.



*Note: you do not have to reveal any information about receipt of alimony, child support or separate maintenance unless you wish to have it considered for repayment for this obligation.



All of the above information is complete, correct and provided to Guardian Finance to obtain the indicated card. I have agreed to interest rates, fees and charges disclosed with this application and in the Disclosure Statement (Agreement). I will receive a copy of the Agreement if my application is approved and I agree to be bound by the Agreement. I authorize Guardian Finance to investigate my credit and employment history and to report the credit experience of any party or authorized user to consumer reporting agencies and others. I understand you will retain this application whether or not it is approved.



IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT - To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.

Applicant's Signature
Co-Applicant's Signature
By checking this box you agree to the terms and conditions above. By checking this box you agree to the terms and conditions above.