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DANIEL'S CREDIT APPLICATION

Please click here for Daniel's Jewelers Preferred Charge Detail Installment Credit Card Agreement Summary Of Terms.

PLEASE TELL US ABOUT YOURSELF
Please note that you must reside in the State of California and be 18 years or older to apply for a Daniel's Card. All purchases must be made at a Daniel's Retail Store.
* Required Fields
First*     Middle     Last*     Suffix  
Social Security #*
Secure and Not Stored Online
   
Date of Birth*
You Must Be 18 Years of Age or Older To Apply
    No. Of Dependents Incl Yourself     Email*
Only applications from customers living in California and Arizona can be accepted
Mailing Address*     Apt     City*     State*     ZIP*  

Date Lived Here Since*     Monthly Payment  
Housing Information*  
Landlord/Property's Owner Name     Landlord/Property's Owner Phone  
Primary Phone #*     Cell #     Message (if no home #)     Name  
If you haven't lived at your current address for at least 2 years, please provide a previous address
Previous Address     Apt     City     State     ZIP  
PLEASE TELL US WHERE YOU WORK
Employer (Give Firm's Full Name)*     Employer's Phone Number*  
Years & Months on Job*     Monthly Net Income From All Sources* *** $   /MONTH

***Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Phone Number to Reach YOU at Work   Department     Occupation/Job Duties  
Supervisor's Name     Supervisor's Telephone Number  

PLEASE GIVE US TWO PERSONAL REFERENCES (Preferably Relatives NOT Living With You)
Nearest Relative 1:   Name*     Phone Number*   Relationship*  
Nearest Relative 2:   Name*     Phone Number*   Relationship*  

DANIEL'S JEWELERS CREDIT APPLICANT: We need you to check ACCEPT button below.
By applying for this account, I am asking Daniel's Jewelers ("Daniel's") to open a credit account for and by signing this agreement I (A) acknowledge receipt of the Daniel's Jewelers Preferred Charge Retail Installment Agreement Summary of Terms, and if approved for this account, to be bound by the full terms and conditions of the Daniel's Jewelers Retail Installment Credit Card Agreement, (B) authorize Daniel's and others working with Daniel's to verify all credit, employment, references, or banking information, obtain current balances on any such accounts, and request information from credit bureau reporting agencies, and, if approved for this account, whether a purchase is charged to this account or not, authorize Daniel's to re-verify, obtain updates on such accounts and to obtain information from and report the payment history and account status of this account to and from credit bureau reporting agencies without my additional authorization or a specific request for purchase approval or credit line increase, (C) understand and agree that I am submitting this application and all of the information on this application to both the designated entities that I have signed for as well as their affiliates and designees for their use in marketing products and services to me as permitted by applicable law, I authorize Daniel's, its affiliates and its designees to submit and disclose this application to another lender or lenders which is/are not affiliated with any of the designated entities on this application, (D) authorize Daniel's to contact me via mail, email, telephone, cellular telephone and any other electronic means, including, but not limited to automated messages without a live operator or agent delivering or available at the time of the contact, including, but not limited to, those contact methods noted above, for account service, collections, sales promotion and other consumer business related matters; standard text messaging and call use rates may apply and will be accepted by me with no reimbursement or payment by Daniel's; calls I make to or receive from Daniel's may be monitored or recorded by Daniel's, (E) understand that in order to discontinue receiving contact for any purpose other than accounts servicing or collection, I can call (310) 846-5630 during regular business hours.
ACCEPT
REFERRAL CODE

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