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Thank you for selecting our Online Credit Application Form. Thank you for your interest in Rose City RV Center

You may apply for a loan by yourself or with another person who may be your spouse or someone else. If you are applying with another person who is not your spouse, that person must fill out a separate application which should be submitted together with your application. Provide information about your spouse if you're married and living in Washington, Idaho or another community property or state, or if you're relying on your spouse's wages to repay us. You do not have to include information on the income from alimony, child support or maintenance unless you want us to consider it in granting credit.

Your E- Mail Address? (required)     Name     Address     City         State         Zip

	PERSONAL PROFILE

Prev. Address (if less than 2 years)                             Employer             Employer Address             Prev. Employer(if less than 2 years)             Nearest Relative(excluding spouse)             SPOUSE PROFILE       Name             Employer             Employer Address           Prev. Employer(if less than 2 years)             Nearest Relative(excluding spouse)

Married   Single   Separated   Own   Rent     City     Other       State   Home Phone           Yrs at address         Zip             No. Family Members         Date of Birth             Years There               Position   Years There       Self EmployedYesNo                   City       State       Position Zip         City          State         Position     City         State           Position     Zip           City          State         Business  Phone     Years There         Self Employed       Yes No       Phone Number     Date of Birth     Years There         Self Employed       Yes No       Business  Phone     Years There         Self Employed       Yes No       Phone Number

OTHER INFORMATION

INCOME

Are you a defendant in a legal action or suit?     Do you guarantee any debt not shown below?       Have you ever declared bankruptcy?

Yes No     Yes No     Yes No

Applicant Monthly Wage     Spouse Monthly Wage     Other (describe below)

	If you answer yes to any of these questions, explain below:		description

APPLICANT’S STATEMENT

	I’VE ANSWERED THE QUESTIONS IN THIS APPLICATION FULLY AND TRUTHFULLY. I UNDERSTAND THAT YOU MAY CHECK MY CREDIT RECORD AND ANY STATEMENTS I’VE MADE. I GIVE ALL  MY CREDITORS PERMISSION TO GIVE YOU ANY INFORMATION YOU NEED TO DETERMINE WHETHER YOU WANT TO GRANT MY CREDIT. I GIVE YOU PERMISSION TO GIVE CREDIT REPORTING AGENCIES AND OTHER CREDITORS INFORMATION RELATING TO ANY CREDIT YOU MIGHT GRANT ME. ALL INFORMATION GIVEN IS AS THIS DATE UNLESS OTHERWISE STATED.

Applicants Signature (type name in space below):         Date           Spouse’s Signature (type name in space below):             I/WE WILL PROVIDE DOCUMENTATION TO VERIFY ANY OF THE ABOVE INFORMATION IF REQUIRED BY LENDER               Please Only Click the "Send Application Button Once. This is a long form and will take a few seconds to process and send. If you click twice, you will send the application twice. Once the form is processed you will automatically exit to the next page.

Date

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