Daniels Jewelers Partner Application Form

Partner Credit Application Form

Please note that you must reside in the State of California, Arizona, Nevada, New Mexico, Texas, Florida, Georgia, New York, North Carolina, South Carolina, Virginia, Ohio, Pennsylvania, Michigan and be 18 years or older to apply for Daniels card.

Note: All fields are required unless noted as optional.

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Customer Account Verification

Date of Birth (MM/DD/YYYY)

Social Security Number/ITIN#

Mobile Verification

To begin, please provide a mobile phone to send verification code. Enter received code to verify.

Mobile Number

Personal Information

First Name

Middle Name (Optional)

Last Name

Suffix (Optional)

Street Address

Apt/Unit (Optional)

ZIP Code

City

State

Email Address

Secondary Phone (Optional)

Housing Information

Employment

Employer's Name

Type of Work/Job Duties

Employment Start Date (MM/YYYY)

Employer's Phone Number

Monthly Net Income (from all sources)

Identification

Primary ID Type

ID Number

ID State

ID Expiration Date (Optional)

Reference Information

Relative Name

Relative Phone

Relationship

Terms & Conditions

DANIEL'S CREDIT APPLICANTS

By applying for this account, I am (we are) asking Daniel's Jewelers ("Daniel's") to open a credit account for me (us) and by signing this agreement I (we):

(A) Credit Agreement. Acknowledge receipt of the Daniel's Retail Charge and Security Agreement and Privacy Policy (available at www.DanielsJewelers.com/Pages/Privacy-Policy), and if approved for this account, to be bound by the full terms and conditions of the Daniel's Retail Charge and Security Agreement.

(B) Credit Authorization. Authorize Daniel's and affiliates 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 (our) specific authorization or a specific request for purchase approval or credit line increase.

(C) Marketing Use. Understand and agree that I am (we are) submitting this application and all of the information on this application to both the designated entities that I (we) 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 (we) authorize Daniel's, its affiliates and its designees to submit and disclose this application to other lender(s) or lease-to-own providers which is/are not affiliated with any of the designated entities on this application.

(D) Contact Authorization. Authorize Daniel's to contact me via mail, email, telephone, cellular telephone, text messaging (SMS or MMS), and any other electronic means, including, but not limited to through automatic telephone dialing systems and/or with artificial or prerecorded voices at, including, but not limited to, those contact methods noted with (+ or *) above, for account service, collections, sales promotion including marketing, and other consumer business related matters. I (we) assume the risk that electronic communications to us (text, email, voice message) may be viewed or accessed by others with access to our device(s). I (we) acknowledge that we may receive up to ten (10) calls and ten (10) text messages per month. I (we) acknowledge that, to opt out now or at any time from receiving calls or texts for any purpose other than accounts servicing or collection, I may call (424) 294-2679 or text "STOP" in response to any text message. I (we) acknowledge that standard text messaging and call use rates may apply and will be accepted by me (us) with no reimbursement or payment by Daniel's; calls I (we) make to or receive from Daniel's may be monitored or recorded by Daniel's for supervisory purposes; I understand that consent for marketing is NOT a condition of purchasing or receiving service and I can opt out at any time.

(E) Opt-Out. Understand that in order to discontinue receiving contact for any purpose other than accounts servicing or collection, I can call (424) 294-2679 during regular business hours.

NOTICE TO BUYER(S):

DO NOT SIGN THIS APPLICATION BEFORE READING THE DANIEL'S RETAIL CHARGE AND SECURITY AGREEMENT OR IF IT CONTAINS BLANK SPACES.

Please click here for Daniel's disclosures including the Retail Charge and Security Agreement. (Enter your address first)

I have reviewed and electronically signed the Application Disclosure and Daniel's Retail Charge and Security Agreement above. Selecting "Submit Application" below constitutes my electronic signature for this credit application.