| Dealer Name: Tegtmeyers Trailer Sales |
Fax: (937)486-2424 Phone: (937)486-2405 |
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APPLICANT
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| Name (First, Middle, Last) |
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| Date of Birth |
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| Social Security Number |
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| No. Dependents (Excluding Yourself) |
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| Time at Address. |
Yrs.
Mos |
| Home Phone |
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| Previous Address |
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| Time at Address |
Yrs.
Mos. |
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Own
Rent
Live with parents |
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Other - Explain:
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| Mortgage/Rent Payment |
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| Approx. Value of Home |
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| Name of Mortgage Holder/Landlord |
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| Mortgage Balance |
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| Name of Current Employer |
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| Address of Current Employer |
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| Position |
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| Time with Employer |
Yrs.
Mos. |
| Business Phone |
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| Monthly Gross Income* |
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| Other Monthly Income* |
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| Previous Employer (If Less Than 3 Years) |
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| Years There |
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| Position |
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| Self Employed/Principal of Corp. |
Yrs.
Mos. |
| * You do not have to reveal alimony, child support, or separate maintenance income unless you wish to have them considered for approving your application. |
| Have You Ever Filed Bankruptcy?
Yes: When:
No |
CREDIT CARD ACCOUNTS:
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MasterCard/Visa/Discover
American/Express/Diners |
| Finance Company (Please List)
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Department Store (Please List)
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Value of All Assets Except Home $
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Total Monthly Payments On All Debts
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Except Mortgage or Rent $
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Total Balance of All Debts Owed
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Except Mortgage $
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NEAREST RELATIVE NOT LIVING WITH YOU
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Name
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Address
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Phone
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| Relationship |
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| CO-APPLICANT |
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| Using a co-app? |
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| Name (First, Middle, Last) |
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| Date of Birth |
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| Social Security Number |
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| Home Phone |
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| Address |
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| Time at Address |
Yrs.
Mos. |
| Self Employed / Principal of Corp. |
Yrs.
Mos. |
| Name of Current Employer |
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| Address of Current Employer |
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| Business Phone |
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| Time with Employer |
Yrs.
Mos. |
| Monthy Gross Income* |
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| Position |
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| * You do not have to reveal alimony, child support, or separate maintenance income unless you wish to have them considered for approving your application. |
| Have You Ever Filed Bankruptcy?
Yes: When:
No |
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| DESCRIPTION OF GOODS BEING PURCHASED: |
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| New or Used |
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| Year |
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| Manufacturer |
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| Model |
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| Type |
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| Length |
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| Invoice |
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| FINANCE TERMS REQUESTED: |
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Cash Price
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| Sales Tax |
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| Cash Down Payment |
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| Amount Financed |
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| Term |
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| Payment Amt |
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| TRADE-IN INFORMATION: |
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| Year |
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| Manufacturer |
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| Model |
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| Type |
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| Length |
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| Amount Owed |
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I hereby affirm that the foregoing information is
true and correct and made for the purpose of obtaining
credit. I authorize you to obtain addition information
from any source(s) and each source is hereby authorized
to provide you with such information. I also grant
you permission to obtain a credit report on me for
all legitimate purposes in connection with this
transaction. Such purposes include assisting in
making a credit decision, reviewing my account,
and assisting in taking collection activity. This
application, in any event, shall be and remain the
property of the Lender, and is subject to the completion
and acceptance of the addition credit application
documents prior to any approved extension of credit. |
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