APPLICANT INFORMATION
Consumer Credit Application
First Name
Last Name
Mid
Date of Birth
USCitizen?
Social security #
Yes
No
Current Street Address
City
St
Zip Code
Length of Residence
Previous Street Address
City
St
Zip Code
Length of Residence
Home Phone w Area Code
Own Rent or Other
Mthy Pmt
Landlord/Mortgage
Own
Rent
Other
Business Phone #
Business/ Employer Name
Occupation
Length of Emp
Previous Business/ Employer Name if with current less than 2 yrs
Occupation
Length of Emp
Gross Monthly Income
Additional Income and Source
Personal References 1:
2:
CO-APPLICANT OR OTHER PARTY INFORMATION:
First Name
Last Name
Mid
Date of Birth
US Citizen?
Social security #
Yes
No
Current Street Address
City
St
Zip Code
Length of Residence
Previous Street Address
City
St
Zip Code
Length of Residence
Home Phone w Area Code
Own Rent or Other
Mthly Pmt
Landlord/Mortgage
Own
Rent
Other
Business Phone #
Business/ Employer Name
Occupation
Length of Emp
Previous Business/ Employer Name if with current less than 2 yrs
Occupation
Length of Emp
Gross Monthly Income
Additional Income and source
Purchase Price
Desired Mn Paymnt
DEALER INFORMATION
Trade In
Durham Trailer Ranch
Pay Off
Term
Sales Person
Net Trade In
Phone: (817) 599-6100
Fax (817) 599-6107
Cash Down
New / Used
Horse Trailer
Other:
Net Down
________________________________________
Net Price
Applicant Signature
Sales Tax
Titling to be done
________________________________________
Other Fees
Lender Dealer
Co - Applicant Signature
Total Finance
Click the Print button to print this form and fax it to: (817) 599-6107