Credit Application

Applicant Information

Co-Applicant Information

Full Name-Last, First, Middle

Birthdate-M/D/Y

Social Security Number

Marital Status

Present Street Address

City, State, Zip Code

How Long at Current Address

Years

Months

Home Phone No.

Residential Status

Previous Address (if less than 3 years at present address)

How long at previous address

Years

Months

Applicant's Employment

Employer's Name

Employer's City, State

Salary (Gross) $

Work Phone

Job Title or Occupation

Hire Date-M/D/Y

Other Income Note: Alimony, child support, or separate maintenance incomes do not have to be revealed unless the applicant wishes to have such sources considered as a basis for repayment of the requested credit

(A) Source of other income

Monthly Amount $

Full Name-Last, First, Middle

Birthdate-M/D/Y

Social Security Number

Marital Status

Present Street Address

City, State, Zip Code

How Long at Current Address

Years

Months

Home Phone No.

Residential Status

Previous Address (if less than 3 years at present address)

How long at previous address

Years

Months

Co-Applicant's Employment

Employer's Name

Employer's City, State

Salary (Gross) $

Work Phone

Job Title or Occupation

Hire Date-M/D/Y

(A) Source of other income

Monthly Amount $

This credit application should be used to apply for financing for a new or used Manufactured Home, Mobile Home, Modular Home, Park Model or HUD Cabin.

Married
Separated
Unmarried (Single, Divorced, Widowed)

Home owner
Parents
Renter
Other

Hour WeekMonthYear

Married
Separated
Unmarried (Single, Divorced, Widowed)

Home owner
Parents
Renter
Other

Hour WeekMonthYear