Applicant
Name
Address
City, State & Zip
Years at Residence
Own
Rent
Other
Monthy Payment
# of Dependents
Home Phone
Social Securty Number
Date of Birth
Drivers License #
Employer
How long have you been employed there?
Total Annual Income
Business Phone
Previous Employment time if less than 2 years
*NOTE: Alimony, child support or seperate maintenance payments need not be disclosed unless relied upon for credit.
Joint Appllicant
Spouse
Previous Employment Time if less than 2 Years
Sales Information
1. Cash Sale Price
1a. Accessories
2. Sales Tax
3. Cash Down Payment
4a. Gross Trade-In
4b. Less Amount owed on Trade-In
4c. Net Trade-In (4a-4b)
6. Total Down Payment
7. Unpaid Cash Sales Price
8a. Filling Fee
8b.Titling Fee
8c.Doc Fee
8d.Other Fees
9. Warranty
10. Amount Financed
Store Use Only
Collateral Information
Select Product Type
RV
HD Motorcycle
Motorcycle
Marine
Horse/Utility Trailer
Living Quarters Trailer
Outdoor Power Equipment
Make
Model
Year
Size/CC's
Length (FT)
Is this Product:
New
Used
If New, Invoice Price:
If Used, Mileage on Vehicle:
Trailer Included with purchase:
Yes
No
N/A
Email Address
