KMR Trailer Sales Financing

Individual or Joint Application *

Individual or Joint Application Individual Joint
Product Inquiry *

Please use stock number if available.
Approx. Amount to Finance *
Identification
Name Name * First Middle Last
Birthdate Birthdate * / MM / DD YYYY
Social Security # *
Must be 9 digits. Currently Entered: 0 digits.
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
Mailing Address (if different from physical) Mailing Address (if different from physical)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Years At Current Residence *
Maximum of 2 digits allowed. Currently Entered: 0 digits.
Enter number in years
Months At Current Residence *
Must be a number less than or equal to 11.
Housing: Do You *

Housing: Do You Own Outright Rent Mortgage Other
Mortgage or Landlord Name *
Monthly Rent/Mortgage *
If less than two years at current home please complete previous residence history:
Previous Physical Address (NO P.O. BOX) Previous Physical Address (NO P.O. BOX)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Previous Mailing Address (if different from physical) Previous Mailing Address (if different from physical)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Years at this residence
Months at this residence
Housing: Did You

Housing: Did You Own Outright Rent Mortgage Other
Mortgage or Landlord Name
Monthly Rent/Mortgage
Contact Information
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 * - ### - ### ####
Email *
How Would You Like To Be Contacted? *
Employment Information
Current employer (Actual Employer) *
Position/Occupation *
Employer Phone Employer Phone * - ### - ### ####
Years At Your Job *
Years At Your Job
Months At Your Job *
Status *
Gross monthly income (before taxes) * $ Dollars . Cents
If less than two years at current job please complete previous employer history:
Previous Employer
Position/Occupation
Previous Employer Phone Previous Employer Phone - ### - ### ####
Years At This Job
Years At This Job
Months At This Job
Status
Other Monthly Income $ Dollars . Cents
Source of Other Monthly Income
Co-Applicant Identification
Name Name First Middle Last
Birthdate Birthdate / MM / DD YYYY
Social Security Number
Must be 9 digits. Currently Entered: 0 digits.
Check here if physical address is the same as applicant
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
Mailing Address (if different from physical) Mailing Address (if different from physical)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Years At Current Residence

Enter number in years
Months At Current Residence
Housing - Do you:

Housing - Do you: Own Outright Rent Mortgage Other
Monthly Rent/Mortgage $ Dollars . Cents
Landlord or Mortgage Name
Contact Information
Home Phone Home Phone - ### - ### ####
Cell Phone Cell Phone - ### - ### ####
Email
How Would You Like To Be Contacted?
Employment Information
Current employer (Actual Employer)
Position/Occupation
Employer Phone Employer Phone - ### - ### ####
Years At This Job
Years At This Job
Months At This Job
Status
Gross Monthly Income (before taxes) $ Dollars . Cents
If less than two years at current job please complete previous employer history:
Previous Employer (if less than 2 years at present)
Position/Occupation
Previous Employer Phone Previous Employer Phone - ### - ### ####
Years At This Job
Years At This Job
Months At This Job
Status
Other 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
Dealer Information
Product Type
Submitted By
New or Used

New or Used New Used
Trailer Year
Trailer Make
Trailer Model
Purchase Price $ Dollars . Cents
Down Payment $ Dollars . Cents
Sales Tax $ Dollars . Cents
Titling Fees $ Dollars . Cents
Trade-In $ Dollars . Cents
Other $ Dollars . Cents
Total Amount to Finance $ Dollars . Cents
Credit Report Authorization

I certify that the information provided by me is correct. I also understand that you will be checking with credit reporting agencies. I authorize an investigation of my credit and employment history and the release of information about my credit experience. I have read and received a copy of your Privacy Notice and agree to all of the above.
Initials *
Signature *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

KMR Trailer Sales Financing

Identification

Contact Information

Employment Information

Co-Applicant Identification

Contact Information

Employment Information

Dealer Information

Credit Report Authorization