CALL or TEXT: Mt Vernon: (618) 242-0800

Trailers by Type

Credit Application

* Required Field

BRAND & AMOUNT TO FINANCE

Brand *

Amount to Finance *

APPLICANT INFO

First Name *

Middle Initial

Last Name *

Date of Birth *

Social Security Number *

Driver's License Number *

Driver's License State *

Driver's License Expiration Date *

Home Phone *
(Please Include Area Code)

Email *

Cell Phone
(Please Include Area Code)

Address *

City *

State *

Zip *

Nearest Relative Name *

Nearest Relative City *

Nearest Relative State *

Nearest Relative Phone Number *
(Please Include Area Code)

HOUSING INFO

Residence (own or rent) *

Mortgage Holder / Landlord *

Monthly Payment *

Mortgage Balance

Market Value

Years at this address *

Previous Address (if less than 3 years)

EMPLOYMENT INFO

Employer *

Employment Address *

Employment Address - City *

Employment Address - State *

Employment Address - Zip *

Employer Phone *
(Please Include Area Code)

Length of Employment *

Position *

Gross Monthly Income *

Other Monthly Income

Other Income Source
[Note: Alimony, child support or separate maintenance income need not be revealed unless you wish to have it considered as a basis for repaying this obligation.]

Self-Employed

Primary Banking (checking, savings) *

Monthly Child Support/Alimony Paid

PREVIOUS EMPLOYMENT (IF LESS THAN 2 YEARS AT CURRENT EMPLOYMENT)

Previous Employer

Previous Position

Previous Employer Phone

Previous Length of Employment

Previous Employment Address

Previous Employment Address - City

Previous Employment Address - State

Previous Employment Address - Zip

CO-APPLICANT INFO

First Name

Middle Initial

Last Name

Date of Birth

Social Security Number

Driver's License Number

Driver's License State

Driver's License Expiration Date

Home Phone
(Please Include Area Code)

Cell Phone
(Please Include Area Code)

Address

City

State

Zip

Nearest Relative Name

Nearest Relative City

Nearest Relative State

Nearest Relative Phone Number
(Please Include Area Code)

CO-APPLICANT HOUSING INFO

Residence (own, rent, same as applicant)

Mortgage Holder / Landlord

Monthly Payment

Mortgage Balance

Market Value

Years at this address

Previous Address (if less than 3 years)

Employer

Employment Address

Employment Address - City

Employment Address - State

Employment Address - Zip

Employer Phone
(Please Include Area Code)

Length of Employment

Position

Gross monthly income

Other Monthly Income

Other Income Source
[Note: Alimony, child support or separate maintenance income need not be revealed unless you wish to have it considered as a basis for repaying this obligation.]

Self-Employed

Primary Banking (checking, savings)

Monthly Child Support/Alimony Paid

PREVIOUS EMPLOYMENT (IF LESS THAN 2 YEARS AT CURRENT EMPLOYMENT)

Previous Employer

Previous Position

Previous Employer Phone

Previous Length of Employment

Previous Employment Address

Previous Employment Address - City

Previous Employment Address - State

Previous Employment Address - Zip

TRADE-IN INFO

Year

Manufacturer

Model

Mileage

Pay-Off Amount

STATEMENT OF CONSENT

* Required
By submitting this form, I/we hereby: 1. Understand and agree that you and any lenders you work with may make credit inquiries and employment inquiries about me, may provide and exchange information about me with any source of credit information to which you may apply, and may disclose information about me with other financial institutions for purposes of fulfilling this credit request; 2. Certify that all information I have provided on this Application or in connection with this Application is true, correct and complete, whether completed by me or by you at my direction. I understand that you and the lenders you work with will rely on the information in this credit application in making its decision. I also understand that making false statements in order to obtain credit may be a crime; 3. Certify that I am a US resident; 4. Agree that if credit is approved, the lender may obtain subsequent consumer reports in connection with reviewing the account, and taking collection action on the account, or for other legitimate purposes associated with the account; 5. Provide my express written consent for you and/or the lender to contact me, in connection with my loan, at the cell phone number(s) and email address(s) provided.

I agree I disagree