RV / Boat Secure Online Credit Application - Gulfcoast Funding

SECURE APPLICANT INFORMATION:					* required fields
First Name *	Initial	Last Name *	SSN *	Birth Date *	US Citizen
					Yes No
Home Address: Street *		City *		State *	Zip *
Years	Own or Rent?		Monthly Payment	Phone *	Dependents
	Own Rent
Previous Address (If at present home less than 3 years)			Nearest Relative	Email *	Phone
EMPLOYMENT DATA:
Present Employer Name, Address, Phone *			Length of Employment	Work Phone *
Position				Salary
				$ per Select month year
Previous Employer Name, Address, Phone				Length of Employment
Other Income Sources	Describe				Annual Amount
Alimony, child support or other maintenance payments need not be revealed.
Have you ever filed bankruptcy or reorganized or had a repossession? Yes No
If this is an application for joint credit with another person, complete all sections, providing information in the CO-APPLICANT section below about the joint applicant.
We intend to apply for joint credit * Select Applicant Co-Applicant
CO-APPLICANT (IF ANY):
First Name	Initial	Last Name	SSN	Birth Date	Dependents
Home Address			Years there		US Citizen
					Yes No
Employer Name, Address, Phone		Length of Employment	Position		Salary
Other Income Sources					Annual Income
BOAT/RV INFORMATION:
New or Used	Manufacturer			Year	Model
New Used
Length	Engine Manufacturer		HP/Engine	Select Fuel type & Engine number
				Fuel Diesel Gas Engine(s) Single Twin
Selling Price	Sales Tax		Cash Down Payment
Trade-In	Amount to Finance		Anchorage
Trade-in Description	Year	Manufacturer	Model	Length	Engines
Seller's Name/Broker's Name				Phone Number
Use:
Pleasure Charter Commercial Live Aboard
All of the statements made by me (us) in this application are true and correct and have been made by me (us) in order to induce you to grant credit to me (us). I (we) have no outstanding obligations except as shown in this application. I (we) have no undisclosed lawsuits or judgments pending or entered against me (us). I (we) understand that consumer reports may be requested from consumer reporting agencies in connection with this application. I (we) understand that upon request; I (we) will be informed whether or not a consumer report was requested. And if a report was requested, informed of the name and address of the consumer-reporting agency that furnished the report. I (we) authorize you to exchange credit information with others in connection with this application. I (we) agree that this application shall be and remain your property whether or not this application is approved. I AGREE (Required) yes
Personal Financial Statement
Personal Financial Statement of:				Date:
I/We make the following statement of all my/our assets and liabilities at the close of business on the date indicated above. Assets Amount Liabilities/Net Worth Amount Cash on Hand $ Notes Payable to Bank, etc. $ Cash in Bank (Name)   Other Liabilities (Itemize) Amount $ $ $ $ Notes & Accts Receivable $ $ $ Loans against Life Insurance $ Life Insurance - CSV $ Real Estate Mortgage Payable $ Marketable Securities $ Other Marketable Securities $ Securities not readily marketable $ Federal & States Income Taxes $ Real Estate (Location) $ Brokers Margin Accounts $ Automobile(s) $ Automobile(s) Value $ Boat(s) $ Boat(s) Value $ Other $ Total Liabilities $     Net Worth $ Total Assets $ Total Liabilities & Net Worth $ * How did you hear about us? Please Select Search Results Media Advertising Marine Listings First Boat/RV RV Communities 360Boating Boating Communities Other