Dealer Application

DEALER CREDIT APPLICATION

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DEALER INFORMATION

Dealer Name

Dealer Representative

Dealer Representative Contact Info

TELL US WHAT YOU ARE LOOKING FOR

UNIT Make/Model/Year

VIN #

Do you have a Bill of Sale?

Click or drag & drop file here to upload

TRAILER Make/Model/Year

VIN #

Do you have a Bill of Sale?

Click or drag & drop file here to upload

FINANCE AMOUNT

Purchase Amount ($)

Trade-In Amount ($) (if applicable)

Balance Owed on Trade ($)

Down Payment ($)

TOTAL AMOUNT REQUESTED ($)

Term Requested:

Or, are you looking for a payment amount ($)?

Payment Amount ($)

APPLICANT

Name *

Social Security # *

Date of Birth *

Drivers License # *

Driver's License

Driver's License Attachment

Click or drag & drop file here to upload

Address *

City *

ZIP Code *

Phone *

Email *

Employer *

Years at Employer *

Job Title *

If less than 2 years, name of previous employer

Gross Annual Income ($) *

Proof of Income

Paystub or Proof of Income Attachment

Click or drag & drop file here to upload

Other Income ($)

Amount of Rent or Mortgage ($) *

CO-APPLICANT

If there is no co-applicant, press Continue at bottom of page.

Name

Social Security #

Date of Birth

Drivers License #

Driver's License Pic

Click or drag & drop file here to upload

Address

City

ZIP Code

Phone

Email

Employer

Years at Employer

Job Title

If less than 2 years, name of previous employer

Gross Annual Income ($)

Proof of Income

Paystub or Proof of Income Attachment

Click or drag & drop file here to upload

Other Income ($)

Amount of Rent or Mortgage ($)

ADDITIONAL COMMENTS

Include any information that you feel may help us process the application:

By submitting this form, I certify that the information is correct. I understand I am giving permission for Western Division to review credit and employment history and contact regarding approval of this application.

Thank you for the application. We will be in touch shortly to discuss the approval of the loan.

Requests are processed during normal business hours Monday - Friday (excluding holidays).