ONLINE CREDIT APPLICATION

1. Personal Information
Name: example: (John A Doe)
S.S.N.: -- example: (33-22-1111)
1. Personal Information
Name: example: (John A Doe)
S.S.N.: -- example: (33-22-1111)
Dependants: example: (3)
Age: example: (42)
Date of Birth: / / 19 example:(03/05/1963)
2. Current Address
Street Address: example: (89765 JOHN RD..)
City: example: (dallas)
State: example: (OH)
Postal Code: example: (98765)
Length At Current Address: example:(10 Years)
County: example: (blue)
Phone Number: example:(800-555-5555)
3. Previous Address
(Skip to "4. Living Status" if you have been at your current address longer than 3 years.)
Street Address: example: (12345 John RD.)
City: example: (Dallas)
State: example: (OH)
Postal Code: example: (98765)
Length At Previous Address: example:(10 Years)
4. Living Status
Marital Status:
Residence:
Purchased Price: example: ($120,000)
Balance Owed: example: ($75,000)
Monthly Payment: example:($1,200)
Leinholder/Landlord: example: (Bank of America)
Market Value: example:($175,000)
5. Current Employment
Employer: example: (Wal-Mart.)
Occupation: example: (General Manager)
Employer Phone Number: example: (800-555-5555)
Gross Monthly Salary: example: ($5,000)
Length of Employment example: (5 Years)
6. Previous Employment
(Skip to "7. Other Income" if you have been at your current employer longer than 3 years.)
Employer: example: (Wal-Mart)
Occupation: example: (General Manager)
Employer Phone Number: example: (800-555-5555)
Gross Monthly Salary: example: ($5,000)
Length of Employment example: (5 Years)
7. Other Income
(Please do not include spouse income in this field. If you would like to include this amount, use the joint application further down)
Other, Monthly: example:($1,000)
Source of Income: example:(Rental Property)
8. Bank/Credit Union Reference
Bank Name: example: (Bank of America)
Account Type:
Credit Card:
9. Nearest Relative
Nearest Relative: example: (Bank of America)
Relative's Address: example: (Nashville, TN)
Relative's Phone Number example:(800-555-5555)
IF NO OTHER APPLICANT SKIP TO #19
10. Personal Information (Secondary Applicant)
Name: example: (John A Doe)
S.S.N.: -- example: (33-22-1111)
Dependants: example: (3)
Age: example: (42)
Date of Birth: / / 19 example:(03/05/1963)
11. Current Address (Secondary Applicant)
Street Address: example: (854 John Rd.)
City: example: (Dallas)
State: example: (OH)
Postal Code: example: (98765)
Length At Current Address: example:(10 Years)
County: example: (Dallas)
Phone Number: example:(800-555-5555)
12. Previous Address (Secondary Applicant)
(Skip to "13. Living Status (Secondary Applicant)" if you have been at your current address longer than 3 years.)
Street Address: example: (46293 John Rd)
City: example: (Dallas)
State: example: (OH)
Postal Code: example: (98765)
Length At Previous Address: example:(10 Years)
13. Living Status (Secondary Applicant)
Marital Status:
Residence:
Purchased Price: example: ($120,000)
Balance Owed: example: ($75,000)
Monthly Payment: example:($1,200)
Leinholder/Landlord: example: (Bank of America)
Market Value: example:($175,000)
14. Current Employment (Secondary Applicant)
Employer: example:(Wal-Mart)
Occupation: example:(General Manager)
Employer Phone Number: example: (800-555-5555)
Gross Monthly Salary: example: ($5,000)
Length of Employment example: (5 Years)
15. Previous Employment (Secondary Applicant)
(Skip to "16. Other Income (Secondary Applicant)" if you have been at your current employer longer than 3 years.)
Employer: example: (Wal-Mart.)
Occupation: example: (General Manager)
Employer Phone Number: example: (800-555-5555)
Gross Monthly Salary: example: ($5,000)
Length of Employment example: (5 Years)
16. Other Income (Secondary Applicant)
(Please do not include spouse income in this field.)
Other, Monthly: example:($1,000)
Source of Income: example:(Rental Property)
17. Bank/Credit Union Reference (Secondary Applicant)
Bank Name: example:(Bank of America)
Account Type:
Credit Card:
18. Nearest Relative (Secondary Applicant)
Nearest Relative: example:(Bank of America)
Relative's Address: example:(Detriot,MI)
Relative's Phone Number example:(800-555-5555)
19. RV Information
(Please enter the details of the new model you would like to finance.)
Year: example:(2007)
Make: example:(Dutchmen)
Model: example:(26L-DSL)
20. Email Information
Email:
21. Send Application
You represent that all information in the application is accurate and complete, that you are competent to enter into contracts, that no bankruptcy proceeding is in progress or anticipated which involves you and that no additional applications for credit with another lender have recently been submitted by you prior to our consideration of this application. We are not obligated to grant you credit and we may retain the application whether or not credit is granted. You agree to pay all fees in connection with this application and your loan. You authorize us to obtain information from others concerning your credit standing and other relevant information impacting on this application and to provide to others information about our experience with you.