RG Trailers Financing Form

Please read the following before completing this form:

"Applicant represents that the information given in this Application is complete and accurate and authorizes us to check with credit agencies, credit references, and other sources disclosed herein investigating the the information given."

Applicant Information
Name Name * First Middle Last
Email *
Social Security # *
Must be 9 digits. Currently Entered: 0 digits.
Birthdate Birthdate * / MM / DD YYYY
Driver's License Number *
Expiration Date *
Marital Status *
U.S. Citizen? *

U.S. Citizen? Yes No
Current Physical Street Address (NO. P.O. Box) Current Physical Street Address (NO. P.O. Box) *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Housing: Do You *

Housing: Do You Rent Own Other
How Long There? *

Enter number in years
Mailing Address (P.O. Box) Mailing Address (P.O. Box) *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Mortgage or Landlord Name *
Monthly Payment *
Home Phone Home Phone * - ### - ### ####

Please include the number that we are most likely to reach you at in case we have questions.
Cell Phone Cell Phone - ### - ### ####
Other Phone Other Phone - ### - ### ####
Previous Address (if current is less than 2 years) Previous Address (if current is less than 2 years)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
How Long?
Employer Information
Occupation *
Years in Field? *
Your Employer *
Years With This Employer *
Employer Phone Employer Phone * - ### - ### ####
Gross Monthly Income * $ Dollars . Cents
Source of Other Income (Alimony, Child Support, etc;)

Source of other income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Monthly Amount $ Dollars . Cents
Previous Employer (if less than 2 years at present)
Years
Co-Applicant Information
Name Name First Middle Last
Social Security Number
Must be 9 digits. Currently Entered: 0 digits.
Birthdate Birthdate / MM / DD YYYY
U.S. Citizen?

U.S. Citizen? Yes No
Marital Status
Current Physical Street Address (NO P.O. BOX) Current Physical Street Address (NO P.O. BOX)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Housing - Do you:

Housing - Do you: Rent Own Other
Mortgage or Landlord Name
Monthly Payment $ Dollars . Cents
Home Phone Home Phone - ### - ### ####
Cell Phone Cell Phone - ### - ### ####
Other Phone Other Phone - ### - ### ####
Previous Address if current is less than 2 years Previous Address if current is less than 2 years
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
How Long?
Occupation
Years in Field
Joint Applicant's Employer
Years
Employer Phone Employer Phone - ### - ### ####
Gross Monthly Income $ Dollars . Cents
Source of Other Income (Alimony, Child Support, etc;)

Source of other income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation
Monthly Amount $ Dollars . Cents
Previous Employer (if less than 2 years at present)
Years
Driver's License Number
Expiration Date
Trailer Information

Please include information about the type of trailer you are interested in purchasing (if known).
Trailer Year
Trailer Make
Trailer Model
Personal Reference #1
(name and contact information)
Personal Reference #2
(name and contact information)
Type the letters you see in the image below.

RG Trailers Financing Form

RG Trailers Financing Form

Applicant Information

Employer Information

Co-Applicant Information

Trailer Information