Fax Your Completed Form To: Golden Gait Trailers  1-704-940-0358

RETAIL CREDIT APPLICATION
Credit Applied For: O Joint    O Individual
 (A married applicant may apply for an individual account.)

1. APPLICANT: For an individual account, please complete this section and sign in Section 3. (Please Print)     Date: ____________
   Last Name     First Name   MI   Suffix   Date of Birth Social Security No

_____________________  

_________________________  

 __  

 ____  

 ___/___/___  

____/___/____

 
Home Phone #DEP        E-mail Address       Driver's License#

(___) ___-_____

 ___

_________________@_______________

   _____________

Present Address (Street Address or P.O. Box Number)

      City

  State    Zip

Yrs.___   ___ Mos.

_____________________________

________________

 ______   _________

Previous Address  (If less than 3 yrs at present)

      City   State    Zip

Yrs.___   ___ Mos.

_____________________________  

________________

 ______   _________

Present Employer  (Name of Company)

      City   State    Zip

Yrs.___   ___ Mos.

_____________________________

________________

______  _________
Title/Position       Income   O Gross O Monthly    Employer Phone

_________________________

  $__________.__

  O Net O Annual

(____) ____-______

Other Income

  O Gross O Monthly     Source   Type of Bank Account #Bank Cards

$______.__

  O Net O Annual

_________________________  

O Checking O Savings      ______
(Alimony, Child Support or Separate Maintenance Income Need Not Be Disclosed Unless Relied Upon For Credit.)

Previous Employer  (If less than 3 yrs at present)

      City   State    Zip

Yrs.___   ___ Mos.

_____________________________

________________

 ______  _________
 O  Buying  O Renting   Mo. Rent/Mtg. pmt.   Personal Reference (Not living with you)    Reference Phone
  O Own

_____________

  ________________________________

(___ )___ - _____

2. JOINT APPLICANT: Complete this section only if this is a joint application and joint applicant will be contractually liable for repayment or if applicant is relying on another party's income. Joint applicant must sign in Section 3.
   Last Name     First Name   MI   Suffix     Date Social Security No

_____________________  

_________________________  

 __  

 ____  

 ___/___/___  

____/___/____

       

Present Address  (Street Address or P.O. Box Number)

      City

  State    Zip

Yrs.___   ___ Mos.

_____________________________

 ________________ ______   _____ 

Present Employer  (Name of Company)

      City   State    Zip

Yrs.___   ___ Mos.

_____________________________

________________

 ______   ______ 
Title/Position       Income   O Gross O Monthly    Employer Phone

________________________

  $_______________

   O Net O Annual

(___)___ - _____

Other Income

  O Gross O Monthly     Source   Type of Bank Account    #Bank Cards

_______________

  O Net O Annual

______________________

O Checking O Savings         ____
(Alimony, Child Support or Separate Maintenance Income Need Not Be Disclosed Unless Relied Upon For Credit.)
3.  APPLICANT / JOINT APPLICANT: Please read and sign below.
Seller will submit your application to the appropriate finance institution for approval.
GGT may share with its affiliates any information regarding you or your applicant, acceptance, or credit experience with GGT. However you may request that this information not be shared with affiliates by notifying GGT by mail or phone at the location shown above or by initialing the line   ____   Please DO NOT share information about me with your affiliates.
GGT may investigate your creditworthiness (including obtaining credit reports and verifying employment information) GGT may request a consumer report from consumer reporting agencies in considering your credit application. GGT may use any credit report obtained in connection with this application for future credit offers.
FROM TIME TO TIME, GGT WILL NOTIFY YOU WHEN ADDITIONAL FINANCIAL SERVICES ARE AVAILABLE, BY TELEPHONE AND/OR MAIL, AND THAT SUCH SERVICES MAY INCLUDE NEGOTIABLE CHECKS WHICH MAY ENDORSE TO OBTAIN A LOAN, OR DESTROY IF YOU DO NOT WISH TO ACCEPT THE LOAN OFFER. IF YOU DO NOT WISH TO RECEIVE THESE SOLICITATIONS, PLEASE STRIKE AND INITIAL THIS PARAGRAPH.
 

_______________________________    _____________
             Applicants Signature                                       Date

 

     _______________________________   ___________
        Joint Applicants Signature                       Date

MERCHANT USE ONLY
       Seller's Fax     Tot. Purchase    Down Pmt. Amount          Trade-In           Net Balance
(___) ___-_____ $________.__ $_________.__ $___________.__  $___________.__
  Seller's Name

     ________________________________

 Seller's Merchandise

     ________________________________
069-00116A Retail and Home Solicitation Application (REV. 04-00)