APPLICANT INFORMATION  
Consumer Credit Application
First Name Last Name Mid Date of Birth USCitizen? Social security #
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
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 #
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
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 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