APPLICANT INFORMATION

NAME (First, Middle, Last)

Date of Birth

Social Security Number

Dependents
No.

CURRENT ADDRESS (Street, City, State, Zip Code)

Telephone Number
(         )

Time at address
______Yrs._______Mths

(  ) Own  (  ) Rent  (  ) Live w/ Parents/Relative        (  ) Other - Explain

Mortgage or Rent Payment $

PREVIOUS ADDRESS (Street, City, State, Zip Code) If less than 2 years Number

Employer's Name and Address

Occupation

Time with Employer
_______Yrs_______Mths

Business Phone
(         )

Monthly Gross Income $

Other Monthly Income
$                          Source

Have you ever had any property repossessed?  (  ) yes (  ) no Do you have any law suits pending against you?  (  ) yes (  ) no Have you ever filed for Bankruptcy?  (  ) yes (  ) no Military Reserve? (  ) yes (  ) no
Status: (  ) Active (  ) Inactive

ASSETS & LIABILITIES

Market Value

Amount Owed
Payment/Mo (Type of Property and Address)

$

$ $  

$

$ $  

$

$ $  

CO-APPLICANT INFORMATION

NAME (First, Middle, Last)

Date of Birth

Social Security Number

 Home Phone Number
(        )

ADDRESS  (Street, City, State, Zip Code)

Time at address ______Yrs._______Mths

Monthly Gross Income
$

Name and Address of Employer

Occupation

Time with Employer _______Yrs_______Mths

Business Phone
(         )

DESCRIPTION OF GOODS BEING PURCHASED

ITEM

New or Used

YEAR

MANUFACTURER

MODEL

BOAT

       

MOTOR

       

TRAILER

       
TRADE-IN INFORMATION
Year
 
Manufacturer
 
Model
 
Type
 
Trade Allowance
$
AMT.Owed
$
Net Amount
$
FINANCE TERMS REQUESTED
TTL Sales Price
$
Sales Tax
$
Trade Amt
$
Cash Down
$
Fees
$
Amt Financed
$
Rate
%
Terms
 
Payment
$

I hereby affirm that the foregoing information is true and correct and made for the purpose of obtaining credit. I authorize you to obtain additional information from each source(s) and each source is hereby authorized to provide you with such information. I also grant you permission to obtain a credit report on me for all legitimate purposes in connection with this transaction. Such purposes include assisting in making a credit decision, reviewing my account and assisting in taking collection activity. I authorize you to share all the foregoing information with the Lender and it's subsidiaries. This application, in any event, shall be and remain the property of the Lender, and is subject to the completion and acceptance of additional credit application documents proper to any approved extension of credit.

Applicants Signature
and Date

Co-Applicants Signature
and Date

Fax to: Tim Greer at The Sports Center (478) 987-5279
or mail to: Sports Center - 1444 Sam Nunn Blvd., Perry, GA 31069