Financing Application

Retail Consumer Credit Application

Vehicle interested in:

New/Used

Year

Make

Model

Stock #

RV Type

Price

Maximum Down Payment

Amount To Be Financed

Salesperson

(A) Applicant

Last Name *

First Name *

Middle Name*

Date of Birth *

Social Insurance #

Dependents Including Self *

Email *

Drivers License # *

Street Address *

Drivers License State *

City *

State/Province *

Postal Code *

How long at this address?

Years *

Months *

Home Phone *

Residential Status *

Monthly Payment *

Marital Status

Landlord or Mortgage Holder's Name

Phone

Balance of Mortgage

Value

Account #

Previous Street Address

City

State/Province

Zip

Closest Living Relative

Any Bankruptcy?

If Yes, When?

U.S. Citizen?

Applicant's Employment

Employer's Name *

City

State/Province

Employer's Business

Supervisor

Job Title Or Occupation

Self Employed?

Hire Date

Salary (Gross)

Salary (Gross) PER

Work Phone

Previous Employer's Name

Start Date

End Date

City

State/Province

Phone

Additional Income**

Source**

Monthly Amount

**NOTE: 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.

(B) Co-Applicant

Last Name

First Name

Middle Name

Date of Birth

Social Insurance #

Dependents Including Self

Drivers License #

Street Address

Drivers License State

City

State/Province

Postal Code

How long at this address?

Years

Months

Home Phone

Residential Status

Monthly Payment

Marital Status

Landlord or Mortgage Holder's Name

Phone

Balance of Mortgage

Value

Account #

Previous Street Address

City

State/Province

Zip

Closest Living Relative

Any Bankruptcy?

If Yes, When?

U.S. Citizen?

Co Applicant's Employment

Employer's Name

City

State/Province

Employer's Business

Supervisor

Job Title Or Occupation

Self Employed?

Hire Date

Salary (Gross)

Salary (Gross) PER

Work Phone

Previous Employer's Name

Start Date

End Date

City

State/Province

Monthly Amount

Additional Income**

Source**

Monthly Amount

**NOTE: 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.

Comments/Questions

AUTHORIZATION: By signing this application you promise that all information is true and complete. You also promise that you have revealed any pending lawsuits or unpaid judgements against you. You intend the seller and/or assignee to rely upon these promises in deciding whether to extend credit to you. You authorize a full investigation of your credit record and your employment history. You also authorize the seller and / or asignee to release information about your credit experience with them.