Brystar Yacht & Marine, Inc 1909 Rr 620 N Austin, Tx 78734

Southwest RV and Marine Consultants

CREDIT APPLICATION (PLEASE PRINT) After completion fax to (702) 425-9453 email to [email protected]

Date______SW Rep ______Yr/Mk/Mdl ______

Down Payment ______Payment ______

NAME______HOME PHONE______

CELL PHONE ______WORK PHONE ______

ADDRESS______CITY, STATE, ZIP ______

HOW LONG HAVE YOU BEEN AT THIS ADDRESS?______HOUSE OR APT.?______

APT#______NAME OF APTS______SOCIAL SEC # ______

DL#______State ______DO YOU OWN OR RENT?______Payment $______

IS THIS RESIDENCE IN YOUR NAME?______IF NOT, WHOSE NAME IS IT______

IS THE ABOVE ADDRESS WHERE YOU ACTUALLY AND PHYSICALLY RESIDE?______(ATTACH PROOF OF RESIDENCE) PREVIOUS ADDRESS ______IF YOU LIVE IN A RURAL AREA TURN THIS COPY OVER AND DRAW A BRIEF MAP OF YOUR RESIDENCE.

DATE OF BIRTH______HEIGHT______WEIGHT______HAIR______

EMPLOYED BY______COMPANY ADDRESS ______

PHONE______

JOB ADDRESS & PHONE______

HOW LONG HAVE YOU BEEN WITH THIS COMPANY______

FOREMAN OR SUPERVISOR______DEPARTMENT&PHONE______

INCOME $______(ATTACH VERIFICATION)

SPOUSE’S NAME______SOCIAL SEC #______

DL#______State _____ DATE OF BIRTH______CELL PH ______

EMPLOYER ______HOW LONG? ______

OFFICE ADDRESS AND PHONE______INCOME $______

EMPLOYED AS______SUPERVISOR ______

(ATTACH VERIFICATION OF EMPLOYMENT AND COPY OF DRIVERS LICENSE) (1) HOW WILL IT BE STORED WHEN NOT IN USE ______GARAGE ______MARINA _____ PUBLIC STORAGE OTHER (DESCRIBE IN DETAIL______(BOAT MUST BE STORED OUT OF WEATHER UNLESS OTHERWISE AGREED)

LIST EXACT ADDRESS OF STORAGE LOCATION______

(AS PER CONTRACT YOU MUST SEND NOTIFICATION OF CHANGE IN STORAGE LOACATION) WHERE WILL THE BOAT BE USED AND FOR WHAT PURPOSE______

WHO WILL SERVICE BOAT ? (NAME ADDRESS & PHONE)______(BOAT MUST BE MAINTAINED AND INSPECTED AS PER CONTRACT) LIST ALL BOATS PREVIOUSLY OWNED ______

LIST YEARS OF BOATING EXPERIENCE AND ANY BOATING COURSES:

______PLACES OF INTEREST-STABLISMENTS FREQUENTED-LIST 5 (CHURCH, CLUB , ETC…)

NAME______ADDRESS______PHONE______

LIST REASONS WHY CREATIVE FINANCING IS NECESSARY (Credit Problems)IN DETAIL: ______

Bank______Account #______(Attach Voided Check)

INSURANCE AGENT______PHONE______

YOU MUST HAVE FULL COVERAGE INSURANCE, YOU ARE REQUIRED TO PROVIDE AN INSURANCE CERTIFICATE BEFORE YOUR BOAT IS DELIVERED. IF YOU DO NOT HAVE AN INSURANCE AGENT ASK OUR REP FOR PHONE NUMBERS TO OUR INSURANCE AGENT. FAILURE TO PROVIDE INSURANCE IS A VIOLATION OF YOUR CONTRACT.

(2) PERSONAL FRIENDS OF YOURS AND YOUR SPOUSE-LIST 6 (LOCAL REFERENCES ARE PREFERRED HERE)

NAME______PHONE (HOME)______PHONE (WORK)______

ADDRESS______CITY, STATE, ZIP______

RELATIVES OF YOURS AND YOUR SPOUSE’S LIST 6 LOCAL OR OUT OF STATE

(3) LIST ALL ASSETS INCLUDING REAL ESTATE, STOCKS/BONDS, AUTOMOBILES, etc. ______

______

LIST ALL VEHICLES OWNED OR DRIVEN (Must Match Attached Registration or Insurance Card)

YEAR______MAKE______MODEL______COLOR______

LICENSE NUMBER______State ______

YEAR______MAKE______MODEL______COLOR______

LICENSE NUMBER______State______

LIST ADDITIONAL OPERATORS OF THE BOAT

NAME______RELATION______

ADDRESS & PHONE ______

PERSON TO CONTACT IN CASE OF EMERGENCY______

ADDRESS AND PHONE NUMBER______

HOW DID YOU FIND ABOUT THIS LOT? AD______DRIVING BY______FRIEND______

This company retains the right to verify all personal information and to deny sale of any boat due to incorrect or false information. You must include the following: *COPY OF CURRENT PHONE BILL AND UTILITY BILL* *COPY OF CURRENT DRIVERS LICENSE* *PROOF OF EMPLOYMENT (If self employed include current bank statement and DBA/INC. paperwork) AUTO REGISTRATION/INSURANCE CARD. FINANCIAL STATEMENT REQUIRED ON ALL BOATS OVER $50,000.00. By signing below you give authorization for verification of this and any other obtainable information now, or at any future date. YOU MUST ATTACH VERIFICATION OF UPFRONT FUNDS

______Signature Spouse

COMPANY USE ONLY:

VERIFIED BY ______DATE ______

APPROVED BY ______DATE______

APPROVAL GIVEN BY ______VERIFIED BY ______DATE ______