Sandy
Creek Marina, Inc.
Phone: 254-559-2815
6512 U.S.
180 West
Fax: 254-559-1774
Breckenridge, TX
76424
Applicant Information
Last:_______________________First:__________________________Middle:______________Jr.
Sr. III Dependents____
Social Security #:_________________________DL#:_________________________D.O.B____________
Married / Single
Home Phone:_____________________________ Mailing
Address:_______________________________
Physical Address:_______________________________City:______________________________ST:____Zip:_________
County:____________________________________Length
Of Residency:___________
Monthly Rent / Mortgage:_________________Mortgage
Balance:_______________Mortgage Co:_____________________
Previous Address(if less than 2yrs):___________________________City:_________________________ST:___Zip:________
Present Employer:_______________________________________Occupation:_________________Self
Employed: Yes/No
Length of Employment:_______________Gross monthly
yearly Income:____________________Phone:________________
Address:_____________________________City:______________________________ST:__________Zip:____________
Previous Employer(if less than 2yrs.)___________________________Occupation:_________________________
Length of Employment:______Address:____________________________City:_________________ST&Zip:____________
Nearest Relative:_______________________________Relation:_____________________Phone:____________________
Address:________________________________City:__________________________________ST:_____Zip:__________
Other Source of Income:_______________________________Bankruptcy:_______Yes________No__________year
filed
Co-applicant Information
Last:_______________________First:__________________________Middle:______________Jr.
Sr. III Dependents____
Social Security #:_________________________DL#:_________________________D.O.B____________
Married / Single
Home Phone:______________________________Mailing
Address:_______________________________
Physical Address:_______________________________City:______________________________ST:____Zip:_________
County:____________________________________Length
Of Residency:___________
Monthly Rent / Mortgage:_________________Mortgage
Balance:_______________Mortgage Co:_____________________
Previous Address(if less than 2yrs):___________________________City:_________________________ST:___Zip:________
Present Employer:_______________________________________Occupation:_________________Self
Employed: Yes/No
Length of Employment:_______________Gross monthly
yearly Income:____________________Phone:________________
Address:_____________________________City:______________________________ST:__________Zip:____________
Previous Employer(if less than 2yrs.)___________________________Occupation:_________________________
Length of Employment:______Address:____________________________City:_________________ST&Zip:____________
Nearest Relative:_______________________________Relation:_____________________Phone:____________________
Address:________________________________City:__________________________________ST:_____Zip:__________
Other Source of Income:_______________________________Bankruptcy:_______Yes________No__________year
filed
Checking Account
Information:__________________________Savings Account Information:_________________________
Debt Information
Debtor:____________________Creditor:________________________Mo
pmt:_____________Balance:______________
Debtor:____________________Creditor:________________________Mo
pmt:_____________Balance:______________
Debtor:____________________Creditor:________________________Mo
pmt:_____________Balance:______________
Debtor:____________________Creditor:________________________Mo
pmt:_____________Balance:______________
Debtor:____________________Creditor:________________________Mo
pmt:_____________Balance:______________
Debtor:____________________Creditor:________________________Mo
pmt:_____________Balance:______________
FOR SANDY CREEK MARINA, INC. USE ONLY
New Mfg. Invoice:___________________Boat Make:__________________________Year:___________Length:_________
Boat Model:____________________Dealer Prep:_______________Engine
Make:______________________H.P:_______
Trailer Included:________Other Equipment:______________________________________________________________
USED Book Value:________________Year:__________Make:______________________Model:_____________________
Term
Requested_______months
Cash Price: $_______________________
Sales Tax: $_______________________
Trade Allowance: $_______________________
Payoff Amt: $_______________________
Cash Down: $_______________________
Fees: $_______________________
Total Amt Financed: $_______________________
Buy signing this application, you promise that
all information is true and complete. You also promise that you have revealed
any pending lawsuits or unpaid judgments against you. You intend the seller
and/or assignee to rely upon these promises in deciding whether to extend
credit to you. You authorize a full investigation of your credit record and
your employment history. You also authorize the seller and/or assignee to
release information about your credit experience with them.
______________________________________________________________
__________
Signature (Applicant)
Date
______________________________________________________________
__________
Signature (Co-Applicant)
Date
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