PRIMARY APPLICANT
CONTACT INFO.

First: MI: Last: JR SR II III

Address: City:

State: Zip: Country:

Email: (ex. joeboater@yahoo.com)

Home Phone: ( ) -

Cell Phone: ( ) -

Date of Birth : 01 02 03 04 05 06 07 08 09 10 11 12 / 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993

Social Security # : - -

Marital Status: Married Unmarried Separated

# of Dependents : 00 01 02 03 04 05 06 07 08 09 10+ Are You a US Citizen? : No Yes

EMPLOYMENT
Employer: Occupation:

Type: Full Time Part Time Self Employed Retired Other

Employment Duration Yrs: 00 01 02 03 04 05 06 07 08 09 10+ Mos: 00 01 02 03 04 05 06 07 08 09 10 11

EMPLOYER CONTACT INFO.
Address: City:

State: Zip: Country:

Phone ( ) - Ext:

FINANCIAL INFO.
Annual Salary $ Bankruptcy? Yes No Yr: 1990- 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Credit: Excellent Good Average Fair Poor Unknown Score: 750+ 700-749 650-699 600-649 550-599 Below 550 Unknow

BOAT INFO.
Specific Boat or Type of Boat Desired:

Down Payment$ Loan Amt:$ Terms: Any 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 12 Years 15 Years 20 Years Other

Additional Info.

CO-APPLICANT (if applicable)
CONTACT INFO.

First: MI: Last: JR SR II III

Address: City:

State: Zip: Country:

Email: (ex. joeboater@yahoo.com)

Home Phone: ( ) -

Cell Phone: ( ) -

Date of Birth : 01 02 03 04 05 06 07 08 09 10 11 12 / 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993

Social Security # : - -

Marital Status: Married Unmarried Separated

# of Dependents : 00 01 02 03 04 05 06 07 08 09 10+ Are You a US Citizen? : No Yes

EMPLOYMENT

Employer: Occupation:

Type: Full Time Part Time Self Employed Retired Other

Employment Duration Yrs: 00 01 02 03 04 05 06 07 08 09 10+ Mos: 00 01 02 03 04 05 06 07 08 09 10 11

EMPLOYER CONTACT INFO.
Address: City:

State: Zip: Country:

Phone ( ) - Ext:

FINANCIAL INFO.
Annual Salary $ Bankruptcy? Yes No Yr: 1990- 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Credit: Excellent Good Average Fair Poor Unknown Score: 750+ 700-749 650-699 600-649 550-599 Below 550 Unknow