FINANCING APPLICATION

Individual or Joint Application
—Please choose an option—IndividualJoint

Product Inquiry

Identification

Full name

Date of Birth

SSN:

Do you consent to a credit check?
—Please choose an option—YesNo

What is your current credit score? If you do not know, you can leave blank.

Marital Status
—Please choose an option—SingleMarriedDivorcedWidow(er)

Are you a US Citizen?
—Please choose an option—YesNo

Drivers License No:

Drivers License Expiration Date

Contact Information

Daytime Phone

Evening Phone

Cell Phone

Email

How would you prefer to be contacted
—Please choose an option—Daytime PhoneEvening PhoneCell PhoneEmail

Address Information

Street Address

Unit / Suite / Apt

City

State

Zip

How long have you lived at the current residence?

Do you own or rent?
—Please choose an option—OwnRent

Monthly Rent/Mtg

If less than two years at residence, please complete previous residence history information below

Street Address

Unit / Suite / Apt

City

State

Zip

How long have you lived at the previous residence?

Employment History

Current Employer

Gross monthly income (before taxes)

Position/Occupation

Employer Phone #

Time spent at current job

If less than two years at current job please complete previous employer history below

Previous Employer

Previous Employer Phone #

Time spent at previous job

Questionnaire

Other Monthly Income

Source of other monthly income

Have you ever filed bankruptcy?
—Please choose an option—YesNo

If yes, when?

Credit Report Authorization

I certify that the information provided by me is correct. I also understand that you will be checking with credit reporting agencies. I authorize an investigation of my credit and employment history and the release of information about my credit experience. I have read and received a copy of your Privacy Notice and agree to all of the above.

Initials

Signature