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| Items to be purchased with this loan:
KnfbReader Mobile including Nokia N86 platform, KnfbReader Mobile software, Talks screen reader, $1,770.00
KnfbReader Mobile including Nokia N86 platform, KnfbReader Mobile software, MobileSpeak screen reader, $1,770.00
KnfbReader Mobile including Nokia N82 platform, KnfbReader Mobile software, Talks screen reader, $1,595.00
KnfbReader Mobile including Nokia N82 platform, KnfbReader Mobile software, MobileSpeak screen reader, $1,595.00
KnfbReader Mobile including Nokia N86 platform, KnfbReader Mobile software, $1,545.00
KnfbReader Mobile including Nokia N82 platform, KnfbReader Mobile software, $1,370.00
KnfbReader Mobile software, 995.00
Nokia 86 Reader platform, configured for use with knfbReader mobile including installation of inactivated software, 550.00
Nokia N82 Reader platform, configured for knfbReader mobile including installation of inactivated software, 375.00
WayFinder Access GPS navigation system, $395.00
Talks screen reader, $295.00
MobileSpeak screen reader, $295.00
Bluetooth keyboard, $130.00
Bluetooth headset, $90.00
Additional Items Not listed To Be Purchased:
Item 1:
Cost of item 1:
Item 2:
Cost of item 2:
Item 3:
Cost of item 3:
Item 4:
Cost of item 4:
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| How do you want these items shipped: |
| Amount of Loan: Length of Loan:
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| Where did you hear about the KnfbReader Mobile:
If Other Selected: |
| If you have a KnfbReader Mobile dealer please list the dealer
name: |
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| APPLICANT PERSONAL INFORMATION: |
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First Name:
Last Name: |
| Address: |
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City:
State:
Zip: |
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Home Phone:
Cell Phone: |
| Email: |
| How Long at Current Residence:
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| Birth Date: Month:
Day:
Birth Year: |
| Marital Status: (if spouse will be contractually liable on loan.)
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| Number of Dependents: |
| Are you a member of the NFB: |
| NFB Leader who could serve as a reference: (national, state, local leader) |
| If you do not have a reference within the NFB please give a personal reference we can contact: |
| Name:
Phone Number:
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| EMPLOYMENT |
| Employer Company Name:
Supervisors Name: |
| Employer Address:
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| Employer City: |
| Employer State:
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| Employer Zip Code: |
| Employer Phone Number:
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| Current Position: |
| Length of Employment:
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| Annual Salary Before Taxes: |
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Is income received:
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| Net Monthly Earned Income: |
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Is income received:
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| Social Security Income: |
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Is income received:
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| Social Security Disability: |
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Is income received:
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| Other Income: |
| Please list additional sources of income such as investments, child support, afdc, etc. |
| Other Income #1:
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Amount: |
Is income received:
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| Other Income #2:
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Amount: |
Is income received:
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Monthly Payment |
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| Enter your monthly rent or mortgage payment: |
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| Enter your total monthly utilities: |
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| Enter your telephone & Internet cost: |
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| Enter your monthly food expenditures |
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| Enter the amount you spend on clothing: |
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| Other Expenses: |
Payment |
Current with Payment? |
| Please list additional expenses such as credit cards, loans, unpaid taxes, other debts, alimony, etc. |
| Other expense #1: |
Payment amount: |
Is payment current:
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| Other expense #2:
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Payment amount: |
Is payment current:
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| Other expense #3:
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Payment amount: |
Is payment current:
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| Other expense #4:
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Payment amount: |
Is payment current:
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| Other expense #5:
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Payment amount: |
Is payment current:
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| Have you ever declared bankruptcy:
If Yes, Date filed: |
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| JOINT APPLICANT PERSONAL INFORMATION:
Note: This portion of the application need only be filled out if there is a joint applicant for this loan. |
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First Name:
Last Name: |
| What is your relationship to the above mentioned application: |
| Address: |
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City:
State:
Zip: |
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Home Phone:
Cell Phone: |
| Email: |
| How Long at Current Residence:
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| Birth Date: Month:
Day:
Birth Year: |
| Marital Status: (if spouse will be contractually liable on loan.)
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| Annual Salary Before Taxes: |
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