Online Secure Financing Application

Type of Application:

SingleJoint

Name:*

First NameMiddle NameLast Name

Date of Birth:*

Date

Social Insurance Number:

Phone Number:*

Area CodePhone Number

Email:*

example@example.com

Status:*

Driver's License Number:

Current Residence:*

RentOwn

Mortgage/Rent Per Month:*

Mortgage Lender:*

Home Value:*

Current Mortgage Balance:*

Current Address:*

Street Address

Street Address Line 2

CityProvince

Postal Code

Previous Address (if less than 2 years)

Street Address

Street Address Line 2

CityProvince

Postal Code

Current Employer:*

Phone Number:*

Employer address:*

Position:*

Years Employed:*

Gross Monthly Income:*

Other Income Source:

Amount Monthly:

Previous Employer (if less than 2 years)

Years Employed:

Joint Applicant Name:

First NameMiddle NameLast Name

Date of Birth:

Date

Social Insurance Number:

Phone Number:

Area CodePhone Number

Email:

example@example.com

Driver's License Number:

Current Residence:

RentOwn

Mortgage/Rent Per Month:

Mortgage Lender:

Home Value:

Current Mortgage Balance:

Current Address:

Street Address

Street Address Line 2

CityProvince

Postal Code

Previous Address (if less than 2 years)

Street Address

Street Address Line 2

CityProvince

Postal Code

Current Employer:

Phone Number:

Employer address:

Position:

Years Employed:

Gross Monthly Income:

Other Income Source:

Amount Monthly:

Previous Employer (if less than 2 years)

Years Employed:

Sales Information:

Name of salesperson:

Description of RV:

Stock #

Price:

In connection with your transaction, the dealership may obtain information about you as described in this notice.

1. We collect nonpublic personal information about you from the following sources: Information we receive from you on applications or other forms; Information about your transactions with us, our affiliates or others; and, Information we receive from consumer reporting agency (e.g., credit bureau).

2. We may disclose all of the information we collect, as described above, to companies that perform marketing services on our behalf or to financial institutions with whom we have joint marketing agreements. We may make such disclosures about you as a consumer, customer, or former customer.

3. We may also disclose nonpublic personal information about you as a customer, customer for former customer to non-affiliated third parties as permitted by law.

4. We restrict access to nonpublic personal information about you to those dealership personnel who need to know that information in order to determine your eligibility for products and services, and to provide you with products and services, and to those who are subject to confidentiality provisions and restrictions that prohibit use of information beyond the performance of specified services. To guard your nonpublic personal information we maintain physical, electronic, and procedural safeguards that comply with federal standards.

I agree to the Terms and Conditions and have read the Privacy Notice

Signature

Co-signer's Signature