<%@ Language=VBScript %> DeMartini RV Sales Consumer Loan Application

Recreational Vehicle Credit Application

Please provide all of the requested information. When you have completed the form, press the "Submit Form" button to send your application to DeMartini RV Sales for processing.  Or if you do not to wish to send your personal information over the internet you may simply print this form and fax it to (530) 272-9413 or ask us to mail you an application.

Motorhome you are submitting credit application for: 
                                                                                  (Please list Item # and Coach Year, Make, & Model)

Salesman you are working with: 

Amount Requested

Desired Down Payment

Requested Term of Loan

Check one:

Individual Credit:  Complete Sections A & C. 
If you are applying for individual credit in your own name and relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit requested.

Joint Credit with Spouse:  Complete all Sections, including Section B.
If you are married and live in California or a community property state.

Joint Credit with Someone Other Than Spouse:  Complete Sections A & C.
Each of you should complete the Application sections of separate applications. If either or both of you are married, you must also provide information about your spouse.

NOTE: APPLICANT, IF MARRIED, MAY APPLY FOR A SEPARATE ACCOUNT.

NOTE: APPLICANT, IF MARRIED MAY APPLY FOR A SEPARATE ACCOUNT.

Primary Applicant

U.S. Citizen Yes . No

First Name
 Mi
 Last Name
 Social Security No
No. of Dependents
 Ages of Dependents
 Driver's License
 State
 Date of Birth
Present Street Address
(Do not use P.O. Box)
 City
 St
 Zip
 How Long?
Previous Street Address
(Do not use P.O. Box)
 City
 St
 Zip
 How Long?
Home Phone
 Work Phone & Extension
Present Employer
 Street Address
 City
 St
 Zip
Current Occupation
 Position/Dept.
 Supervisor
 How Long?
 Monthly
Salary
Source of other monthly income:
Property, Investments, Social Security, CD's, etc.
 Other
Income
Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Alimony, child support, separate maintenance received under:
 Court Order Written AgreementVerbal Understanding
Alimony

Spouse

If not married to each other, please complete separate application

U.S. Citizen . Yes No
First Name
 MI
 Last Name
 Social Security No
No. of Dependents
 Ages of Dependents
 Driver's License
 State
 Date of Birth
Present Street Address
(Do not use P.O. Box)
 City
 St
 Zip
 How Long?
Previous Street Address
(Do not use P.O. Box)
 City
 St
 Zip
 How long?
Home Phone
 Work Phone & Extension
Present Employer
 Street Address
 City
 St
 Zip
Current Occupation
 Position/Dept.
 Supervisor
 How Long?
 Monthly
Salary
Source of other monthly income:
Property, Investments, Social Security, CD's, etc.
 Other
Income
Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Alimony, child support, separate maintenance received under:
 Court Order Written AgreementVerbal Understanding
Alimony


Debts and Obligations

First Mortgage or Rent (Name & Address of Leinholder)
 Market
Value
 Original
Amount
 Current
Balance
 Monthly
Payment
Other Debts (Name & Address of Leinholder)

Credit Cards

Visa
Sears 		MasterCard
Penney's		 Discover Amer Ex Gas Cards Total
Balances 		Total
Payments
Other Creditors

Balance

 Payment
Other Assets

Loan Balance

Current Value

Have you ever had any property repossessed?
Yes No 		Military Reserve ?
Yes No 		Active?
Yes 		Active?
No
Have you ever filed for bankruptcy or is a bankruptcy proceeding in progress or expected?
Yes No 		Do you have any law suits pending against you?
Yes No

Personal References

Nearest Relative Name (Not Living With You)
 Phone No.
          Relative Address (Street, City, State, Zip)
          		Relationship
Personal Reference (Not Related)
 Phone No.
          Personal Reference Address (Street, City, State, Zip)
         

In the following sentence, the applicant/co-applicant is referred to as "I" and the creditor is referred to as "you and your".  I, the undersigned (1) make the above representations, which are certified correct, for the purpose of securing credit; (2) authorize financial institutions to obtain consumer credit reports on me periodically and to gather employment history as they consider necessary and appropriate; (3) authorize your affiliates to obtain consumer credit reports on me; (4) authorize the Dealer's Assignee to share and use information about me, including information on my application, with other entities that are related to it by common ownership or affiliated with it by common control, and (5) understand, that you or any financial institution to whom it is submitted will retain this application whether or not it is approved, and that it is the applicant's responsibility to notify the creditor of any changes of name, address or employment.

The financial institutions named below may be requested to purchase a sales finance contract written, or to be written, in connection with your purchase. You are notified pursuant to the Fair Credit Reporting Act, that your application for credit may be submitted to them or to other financial institutions.
Deere Credit Services, Comerica, The Associates, Key Bank, Bank of America Finance,  US Bank,  West America Bank, Greentree Financial, CIT Financial, Nations Credit, Bank of the West, E*Trade Financial, and Thor Credit.
Check Here and type your initials     (initials)
If you Acknowledge and Agree to All the Conditions and Terms of this Credit Application

Your e-mail address

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