Financing Application

Trailer Information:

You are applying for financing on:

7'x12' 12K Gratimax Dump
Stock #: 00202
Price: $10,499

Statement of Consent:

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.

YOUR CREDIT APPLICATION IS GOING THROUGH A SECURE WEBSITE AND YOUR IDENTITY IS SAFE

Trailer Information:

Type: *

Year: *

Condition: *

Make: *

Model: *

Down Payment:

Preferred Length of Financing:

Your Contact Information:

Enter your name as it appears on drivers license
Fields marked with * are required

First Name: *

Last Name: *

Driver's License: *

Driver's License Expiration Date: *

Email Address: *

Phone Number:

Social Security Number: *

Male / Female:

Date of Birth: *

Marital Status:

Business Name (if used for Business):

Physical Address Information:

Physical Address: *

City: *

State: *

Zip: *

County: *

Housing Information:

Do you Rent or Own your home, or other?:

LandLord / Mortgage Holder:

Rent / Mortgage Monthly Amount:

Mortgage Balance:

Years/Months at Current Residence:

Previous Residence (If less than 5 years at Current Residence):

Address:

City:

State:

Zip:

Years/Months at Previous Residence:

Employer Information:

Occupation: *

Employer Name: *

Employer Address: *

Employer City: *

Employer State: *

Employer Zip: *

Employer Phone: *

Salary (Annually Gross): *

Years/Months at Employer: *

Type of Employment:

Other Income:

Other Income Frequency:

Nearest Relative Information (This relative can not live in the same house):

Name: *

Phone: *

City: *

State: *

Additional Comments:

Please include any information that you feel may help us process your application.

I Am Human