Driftwood RV Center

APPLICANT INFO

Stock Number:

First Name:*

Middle Initial:

Last Name:*

Date of Birth:*

Social Security Number:*

Driver's License Number:*

Home Phone:*

Email:*

Cell Phone:

Address:*

City:*

State:*

Zip:*

HOUSING INFO

Residence:* Own Rent

Mortgage Holder/Landlord:*

Monthly Payment:*

Mortgage Balance:

Market Value:

Year At This Address:*

Previous Address if Less than 3 years:

EMPLOYMENT INFO

Employer:*

Address:*

City:*

State:*

Zip:*

Employer Phone:*

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: Yes No

Primary Banking:* Checking Savings

Monthly Child Support/Alimony Paid:

PREVIOUS EMPLOYER, IF LESS THAN 2 YEARS AT CURRENT EMPLOYER

Employer:

Position:

Employer Phone:

Length of Employment:

Address:

City:

State:

Zip:

TRADE-IN INFO

Year:

MFG:

Model:

Mileage:

Pay-off Amount:

CO-APPLICANT INFO

First Name:

Middle Initial:

Last Name:

Date of Birth:

Social Security Number:

Driver's License Number:

Home Phone:

Email:

Cell Phone:

Address:

City:

State:

Zip:

CO-APPLICANT HOUSING INFO

Residence: Own Rent Same as Applicant

Mortgage Holder/Landlord:

Monthly Payment:

Mortgage Balance:

Market Value:

Year At This Address:

Previous Address if Less than 3 years:

CO-APPLICANT EMPLOYMENT INFO

Employer:

Address:

City:

State:

Zip:

Employer Phone:

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: Yes No

Primary Banking: Checking Savings

Monthly Child Support/Alimony Paid:

CO-APPLICANT PREVIOUS EMPLOYER, IF LESS THAN 2 YEARS AT CURRENT EMPLOYER

Employer:

Position:

Employer Phone:

Length of Employment:

Address:

City:

State:

Zip:

Park Models

Travel Trailers

Fifth Wheels

Pop Ups

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