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Fax Your Completed
Form To: Golden Gait Trailers 704-743-5291
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RETAIL CREDIT APPLICATION
Credit Applied For: O
Joint O
Individual
(A married applicant may apply for an individual account.)
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1. APPLICANT: For an individual account, please complete
this section and sign in Section 3. (Please Print)
Date: ________ |
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| Last Name
|
First Name |
MI |
Suffix
|
Date
of Birth |
Social Security No
|
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_____________________
|
_________________________
|
__
|
____
|
___/___/___
|
____/___/____
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| |
| Home Phone
|
#DEP
|
E-mail Address |
Driver's License# |
|
(___) ___-_____
|
___
|
________________________________
|
_____________
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Present Address
(Street Address or P.O. Box Number)
|
City |
State
|
Zip
|
|
Yrs.___
Mos.___
|
_____________________________
|
________________
|
______ |
_________ |
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Previous Address
(If less than 3 yrs at present)
|
City |
State
|
Zip
|
|
Yrs.___
Mos.___
|
_____________________________
|
________________
|
______ |
_________ |
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Present Employer
(Name of Company)
|
City |
State
|
Zip
|
|
Yrs.___
Mos.___
|
_____________________________
|
________________
|
______ |
_________ |
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| Title/Position
|
Income |
O
Gross |
O Monthly
|
Employer
Phone |
|
_________________________
|
$__________.__
|
O
Net |
O Annual
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(____) ____-______
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|
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Other Income
|
O
Gross |
O
Monthly
|
Source |
Type of Bank Account |
#Bank Cards |
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$______.__
|
O
Net |
O
Annual |
_________________________
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O
Checking
O Savings |
______
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(Alimony, Child Support or Separate Maintenance
Income Need Not Be Disclosed Unless Relied Upon For Credit.)
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Previous
Employer
(If less than 3 yrs at present)
|
City |
State
|
Zip
|
|
Yrs.___
Mos.___
|
_____________________________
|
________________
|
______ |
_________ |
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| O
Buying |
O
Renting |
Mo. Rent/Mtg. pmt. |
Personal Reference (Not living with you) |
Reference Phone |
| O
Own |
|
_____________
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________________________________
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(___ )___ - _____
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| 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.
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| Last Name
|
First Name |
MI |
Suffix
|
Date
|
Social Security No
|
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_____________________
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_________________________
|
__
|
____
|
___/___/___
|
____/___/____
|
|
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| |
|
|
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Present Address
(Street Address or P.O. Box Number)
|
City |
State
|
Zip
|
|
Yrs.___
___ Mos.
|
_____________________________
|
________________ |
______ |
_____ |
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Present Employer
(Name of Company)
|
City |
State
|
Zip
|
|
Yrs.___
___ Mos.
|
_____________________________
|
________________ |
______ |
______ |
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| Title/Position
|
Income |
O
Gross |
O Monthly
|
Employer
Phone |
|
________________________
|
$_______________
|
O
Net |
O Annual
|
(___)___ - _____
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Other Income
|
O
Gross |
O Monthly
|
Source |
Type of Bank Account |
#Bank Cards |
|
_______________
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O
Net |
O Annual
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______________________
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O Checking
O Savings |
____ |
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(Alimony, Child Support or Separate Maintenance
Income Need Not Be Disclosed Unless Relied Upon For Credit.)
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| 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.
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| 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. |
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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.
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_______________________________
_____________
Applicants
Signature
Date
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_______________________________ ___________
Joint Applicants Signature
Date
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| MERCHANT USE
ONLY |
|
Seller's Fax |
Tot. Purchase |
Down Pmt.
Amount |
Trade-In |
Net Balance |
| (___) ___-_____ |
$________.__ |
$_________.__ |
$___________.__ |
$___________.__ |
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Seller's Name
________________________________
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Seller's Merchandise
________________________________
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| 069-00116A
Retail and Home Solicitation Application (REV. 04-00)
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