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Credit Application


Please enter the requested information below , then click the Send button.


PRELIMINARY INFORMATION
     
Type of Application: INDIVIDUAL          JOINT
     
Residential Status Marital Status
 

VEHICLE DESIRED
     
Year, Make and Model Color
 

     
Email Address  
 
Physical Address  
Mailing Address (P.O. Box)  
City, State & Zip  
How long at this address Years           Months
 
 
Social Security Number  
Date of Birth  
 
Drivers License #  
Rent/Mortgage Payment  

EMPLOYMENT & INCOME INFO
     
 
 
 
Monthly Income (Before Taxes)
Length of Employment Years           Months
  
 
Other Income  
Source of Other Income  
Previous Employer Name  
Length of Employment Years           Months
  
 

REFERENCES
     
Relative #1 not living with you

Relationship to You
Phone
City, State & Zip

Relative #2 not living with you

Relationship to You

Phone

City, State & Zip

Reference 3

Phone

City, State & Zip

BANKING INFORMATION
     
Type of Account Bank Name  
Checking  
Saving  

AUTHORIZATION

Please read before signing below. By my signature I certify that I have completed this application for the purposes of obtaining credit for purchase of a product from Blue Ridge Powersports (hereafter referred to as Seller). I have authorized Seller to obtain a credit report for this purpose and to share my credit information with their lending partners for the purpose of obtaining a loan for this purchase. I further authorize lending partners to communicate the reason for actions taken on this application. I authorize Seller and lending partners to make inquires about me as they deem appropriate for the purposes of evaluating this application and for any update, renewal, or extension of the credit received. This includes but not limited to credit reports and contacting my employer and/or references. I authorize Seller to share information with anyone who has agreed to pay debts on the basis of this application. I am aware that my information will NOT be used by Seller for marketing purposes. I am aware that Seller and lending partners are legally required to preserve this application and related records in accordance with government guidelines.


By placing my initials and date in the spaces below and submitting this form, I am agreeing to the authorization as outlined in the stipulations above.

Initials

Date

 

 




 

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