Finance Form | Jacksonville, Texas

equipment details

application type

Application type*

applicant personal information

First name*

Last name*

Date of birth*

Social security number*

Email*

Phone*

Marital status*

Citizenship status*

applicant residential information

Physical address*

Physical address 2

City*

State*

Zip*

County*

Own or rent home*

Monthly housing payment*

Years at residence*

Months at residence*

Mortgage company/landlord*

applicant previous residential information

Previous physical address*

Previous physical address 2

Previous city*

Previous state*

Previous zip*

Previous years at residence*

Previous months at residence*

Applicant Employment & income

Employer or business name*

Years with employer or business*

Months with employer or business*

Work phone*

Job title/occupation*

Monthly gross*

Monthly net*

Other income

Other income source

Employer city*

Employment status*

Previous employer or business name*

Previous years with employer or business*

Previous months with employer or business*

Previous work phone*

Applicant Identification

Driver's license #*

Driver's license expiration date*

Driver's license state*

Secondary id*

Secondary id type*

Applicant Bank accounts

Savings account*

Checking account*

Applicant Nearest relative

Nearest relative first name*

Nearest relative last name*

Nearest relative city*

Nearest relative phone*

Nearest relative state*

co-applicant personal information

First name*

Last name*

Date of birth*

Social security number*

Email*

Phone*

Marital status*

Citizenship status*

co-applicant residential information

Physical address*

Physical address 2

City*

State*

Zip*

County*

Own or rent home*

Monthly housing payment*

Years at residence*

Months at residence*

Mortgage company/landlord*

co-applicant previous residential information

Previous physical address*

Previous physical address 2

Previous city*

Previous state*

Previous zip*

Previous years at residence*

Previous months at residence*

Co-Employment & income

Employer or business name*

Years with employer or business*

Months with employer or business*

Work phone*

Job title/occupation*

Monthly gross*

Monthly net*

Other income

Other income source

Employer city*

Employment status*

Previous employer or business name*

Previous years with employer or business*

Previous months with employer or business*

Previous work phone*

co-applicant Identification

Driver's license #*

Driver's license expiration date*

Driver's license state*

Secondary id*

Secondary id type*

co-applicant Bank accounts

Savings account*

Checking account*

co-applicant Nearest relative

Nearest relative first name*

Nearest relative last name*

Nearest relative city*

Nearest relative phone*

Nearest relative state*

Financial information

Amount requested*

Down payment*

Term requested*

REVIEW & SUBMIT

By filling out and signing this Application for Credit ("Application"), you are agreeing to allow Preferred Equipment, LLC. to apply for credit, insurance and warranty products on your behalf. This Application is for use with Preferred Equipment, LLC. and their Lenders ("The Lenders").

Additionally, by signing you agree to the following statement:

I authorize Preferred Equipment, LLC., as my agent, to: (i) submit information from this Application to The Lenders on my behalf; (ii) certify to The Lenders the accuracy of the information; and (iii) convey to The Lenders my consent to any policies, notices, agreements or other terms disclosed by The Lenders to applicants as part of The Lenders’ application process. I have read this Application and everything stated in it is true to the best of my ability. I authorize The Lenders to check my credit, employment history, or any other information, and to report such information, and its credit experience with me, to others. I am at least 18 years of age. Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

I hereby certify that the property purchased pursuant to this application is for my personal and/or business use; that I am fully responsible for making all payments for such property; that such property will be in my possession or under my control until the amount financed and all finance charges have been paid in full; and that I am not purchasing any property financed through The Lenders for the benefit or use of another without the prior written approval of The Lenders.

IMPORTANT INFORMATION ABOUT ACCOUNT OPENING PROCEDURES: Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who requests to open an account prior to account opening.

WHAT THIS MEANS TO YOU: When you apply for credit, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents. Failure to provide the required information may result in denial of your request to open an account.