Credit Application

Accepted By:

LAKESHORE RV
4500 E. Apple Ave
Muskegon, Michigan 49442
Phone: 231-788-2040 FAX: 231-788-5205
 
First:   Last:   Dependents:   Date of Birth:  
Address:   Phone:   County:   Social Security#  
City:   State/Prov:   Zip:   Drivers License :  
Years There : (If less than 2 years) Previous Address:  
* EMPLOYER *
Name:   Occupation:  
City, State, Zip :  ,     Time on job
(years): 		 
Phone Number :   Annual Salary :  
Source of other income:   Amount per month :  
* CREDITOR INFORMATION *
Landlord/Mortgage Holder :   Creditors Payment
Monthly mortgage or rent :   1.    
Personal Bank :   2.    
Personal Banking : [  ] Checking 3.    
[  ] Savings Do you pay child support or alimony? NO
Ever filed for bankruptcy? NO If so what is your monthly payment?  
* JOINT APPLICANT *
First:   Last:   Relation:   Date of
Birth:		  
Address:   Phone:   County:   Social
Security#		  
City:   State/Prov:   Zip:   Drivers
License :		  
* JOINT APPLICANT EMPLOYER *
Name:   Occupation:  
City, State, Zip :  ,     Time on job
(years):		  
Phone Number :   Annual salary :  
Source of other income:   Amount per month:
 
Ever filed for bankruptcy? NO Pay child support or alimony? NO Monthly Payment  
* FOR DEALER USE ONLY *
New   Used   Term   MSRP  
Year   Cash Price  
Make   Down Payment  
Model   Total Financed  

I/WE CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND COMPLETE TO THE BEST OF MY/OUR KNOWLEDGE
Applicant Signature   Date   Joint App's Signature   Date