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All contents © 2012 Southern Mutual Help Association, Inc., all rights reserved.

Credit Authorization

I, , and hereby authorize Southern Mutual Help, Inc. to pull a preliminary credit report.

Applicant #1:
Signature of first applicant [Handwritten]
Social Security Number
Date of Birth
Home Telephone Number
Work Telephone Number
Mailing Address
City, State Zip	, LA

Applicant #2:
Signature of second applicant [Handwritten]
Social Security Number
Date of Birth
Home Telephone Number
Work Telephone Number
Mailing Address
City, State Zip	, LA

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Fill out and print this form and mail with your check or money order:

Southern Mutual Help Association
3602 Old Jeanerette Road
New Iberia, LA 70563

Fee Schedule:

Married Couple: $25
Single Applicant: $25
Two Unmarried Applicants (without joint credit): $50

If you have questions, call our Housing Department at 337-367-3039 or toll free at 1-877-532-1470.