POUGHKEEPSIE FINANCE – Vnose Trailers

FINANCE APPLICATION

Name

First

Last

Middle

Email*

Phone*

Current Address*

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code

Mailing Address(FILL IF DIFFERENT THEN CURRENT)

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Social Security #*

Date of Birth*

day

month

year

Monthly Housing Payment*

Years at Residence *

Current Employers Name*

Work Phone

Job Title*

Years of Employment*

Gross Monthly Income*

Other Monthly Income

Source of Other Monthly Income

Nearest Relative's Name*

Nearest Relative's Phone #*

Nearest Relative's City*

Nearest Relative's State*

Make*

Size*

Down Payment (At Least 10%)*

By submitting this information, the Applicant and/or Co-applicant (hereinafter referred to as “you” and “your”) (1) make the above representations, and certify that they are true and complete for the purpose of securing credit; (2) authorize(s) Vnose Trailers (hereinafter referred to as “the Company”) to obtain credit reports or similar consumer reports about you from one or more consumer reporting agencies in connection with your Application and give information concerning the transaction and its credit experience with you to others; and (3) understand(s) that the Company will retain this application, whether or not it is approved, and that it is your responsibility to notify the Company of any change of name, address or employment. The Company may, at its discretion, assign a sales finance contract written, or to be written, in connection with your purchase to a lending institution of its choosing. You are notified, pursuant to the Fair Credit Reporting Act, that your application may be submitted for consideration to one or more institutions.*