* Required Field |
Applicant Information
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First Name *
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Middle Initial
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Last Name *
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Date of Birth *
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(Ex. 12/12/12)
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Social Security Number *
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(Ex. 123-45-6789)
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Driver's License Number *
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(Ex. F255-921-50-094-0)
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Home Phone *
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(Ex. 123-456-7890)
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Email *
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Cell Phone
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(Ex. 123-456-7890)
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Address *
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City *
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State *
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Zip *
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(Ex. 12345)
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Housing Information
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Residence
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Mortgage Holder/Landlord *
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Monthly Payment *
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Mortgage Balance
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Market Value
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Years at Address (Yrs. / Mos.) *
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Previous Address
(If at current address less than 3 years)
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Employment Information
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Employer *
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Address *
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City *
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State *
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Zip *
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Employer Phone *
(Please Include Area Code)
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Length of Employment (Yrs. / Mos.) *
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Position *
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Gross Monthly Income *
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Other Monthly Income
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Other Income Source [Note: Alimony, child support or separate maintenance income need not be revealed unless you wish to have it considered as a basis for repaying this obligation.]
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Self Employed
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No
Yes
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Primary Banking *
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Checking
Savings
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Monthly Child Support/Alimony Paid
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Previous Employer
(if at current employer less than two years)
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Previous Position
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Previous Employer Phone
(Please Include Area Code)
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Previous Length of Employment
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Previous Employer Address
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Previous Employer City
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Previous Employer State
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Previous Employer Zip
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Co-Applicant Information
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First Name
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Middle Initial
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Last Name
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Date of Birth
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Social Security Number
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Driver's License Number
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Home Phone
(Please Include Area Code)
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Email
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Cell Phone
(Please Include Area Code)
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Street Address
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City
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State
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Zip
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Co-Applicant Housing Information
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Residence
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Mortgage Holder/Landlord
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Monthly Payment
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Mortgage Balance
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Market Value
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Years at this Address (Yrs. / Mos.)
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Previous Address
(If less than three years)
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Co-Applicant Employment Information
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Employer
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Address
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City
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State
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Zip
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Employer Phone
(Please Include Area Code)
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Length of Employment (Yrs. / Mos.)
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Position
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Gross Monthly Income
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Other Monthly Income
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Other Income Source [Note: Alimony, child support or separate maintenance income need not be revealed unless you wish to have it considered as a basis for repaying this obligation.]
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Self Employed
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No
Yes
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Primary Banking
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Checking
Savings
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Monthly Child Support/Alimony Paid
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Previous Employer
(if at current employer less than two years)
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Previous Position
|
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Previous Employer Phone
(Please Include Area Code)
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Previous Length of Employment
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Previous Employer Address
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Previous Employer City
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Previous Employer State
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Previous Employer Zip
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Comments
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Trade-in Information
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Year
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MFG
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Model
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Mileage
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Pay-Off Amount
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Other
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Tell Us About the RV You're Interested In:
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Sales Person You have Been Working With:
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STATEMENT OF CONSENT
By submitting this form, I/we hereby: 1. Understand and
agree that you and any lenders you work with may make credit inquiries and employment inquiries
about me, may provide and exchange information about me with any source of credit information to
which you may apply, and may disclose information about me with other financial institutions for
purposes of fulfilling this credit request; 2. Certify that all information I have provided on this
Application or in connection with this Application is true, correct and complete, whether completed
by me or by you at my direction. I understand that you and the lenders you work with will rely on the
information in this credit application in making its decision. I also understand that making false
statements in order to obtain credit may be a crime; 3. Certify that I am a US resident; 4. Agree that if
credit is approved, the lender may obtain subsequent consumer reports in connection with reviewing
the account, and taking collection action on the account, or for other legitimate purposes associated
with the account; 5. Provide my express written consent for you and/or the lender to contact me, in
connection with my loan, at the cell phone number(s) and email address(s) provided. “I agree” and “I
disagree” – [must agree in order to submit]. [*=Required field].
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I agree*
I disagree
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