<p> Southwest RV and Marine Consultants</p><p>CREDIT APPLICATION (PLEASE PRINT) After completion fax to (702) 425-9453 email to [email protected]</p><p>Date______SW Rep ______Yr/Mk/Mdl ______</p><p>Down Payment ______Payment ______</p><p>NAME______HOME PHONE______</p><p>CELL PHONE ______WORK PHONE ______</p><p>ADDRESS______CITY, STATE, ZIP ______</p><p>HOW LONG HAVE YOU BEEN AT THIS ADDRESS?______HOUSE OR APT.?______</p><p>APT#______NAME OF APTS______SOCIAL SEC # ______</p><p>DL#______State ______DO YOU OWN OR RENT?______Payment $______</p><p>IS THIS RESIDENCE IN YOUR NAME?______IF NOT, WHOSE NAME IS IT______</p><p>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.</p><p>DATE OF BIRTH______HEIGHT______WEIGHT______HAIR______</p><p>EMPLOYED BY______COMPANY ADDRESS ______</p><p>PHONE______</p><p>JOB ADDRESS & PHONE______</p><p>HOW LONG HAVE YOU BEEN WITH THIS COMPANY______</p><p>FOREMAN OR SUPERVISOR______DEPARTMENT&PHONE______</p><p>INCOME $______(ATTACH VERIFICATION)</p><p>SPOUSE’S NAME______SOCIAL SEC #______</p><p>DL#______State _____ DATE OF BIRTH______CELL PH ______</p><p>EMPLOYER ______HOW LONG? ______</p><p>OFFICE ADDRESS AND PHONE______INCOME $______</p><p>EMPLOYED AS______SUPERVISOR ______</p><p>(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)</p><p>LIST EXACT ADDRESS OF STORAGE LOCATION______</p><p>(AS PER CONTRACT YOU MUST SEND NOTIFICATION OF CHANGE IN STORAGE LOACATION) WHERE WILL THE BOAT BE USED AND FOR WHAT PURPOSE______</p><p>WHO WILL SERVICE BOAT ? (NAME ADDRESS & PHONE)______(BOAT MUST BE MAINTAINED AND INSPECTED AS PER CONTRACT) LIST ALL BOATS PREVIOUSLY OWNED ______</p><p>LIST YEARS OF BOATING EXPERIENCE AND ANY BOATING COURSES:</p><p>______PLACES OF INTEREST-STABLISMENTS FREQUENTED-LIST 5 (CHURCH, CLUB , ETC…)</p><p>NAME______ADDRESS______PHONE______</p><p>NAME______ADDRESS______PHONE______</p><p>NAME______ADDRESS______PHONE______</p><p>NAME______ADDRESS______PHONE______</p><p>NAME______ADDRESS______PHONE______</p><p>LIST REASONS WHY CREATIVE FINANCING IS NECESSARY (Credit Problems)IN DETAIL: ______</p><p>Bank______Account #______(Attach Voided Check)</p><p>INSURANCE AGENT______PHONE______</p><p>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.</p><p>(2) PERSONAL FRIENDS OF YOURS AND YOUR SPOUSE-LIST 6 (LOCAL REFERENCES ARE PREFERRED HERE)</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>RELATIVES OF YOURS AND YOUR SPOUSE’S LIST 6 LOCAL OR OUT OF STATE</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>NAME______PHONE (HOME)______PHONE (WORK)______</p><p>ADDRESS______CITY, STATE, ZIP______</p><p>(3) LIST ALL ASSETS INCLUDING REAL ESTATE, STOCKS/BONDS, AUTOMOBILES, etc. ______</p><p>______</p><p>______</p><p>______</p><p>______</p><p>LIST ALL VEHICLES OWNED OR DRIVEN (Must Match Attached Registration or Insurance Card)</p><p>YEAR______MAKE______MODEL______COLOR______</p><p>LICENSE NUMBER______State ______</p><p>YEAR______MAKE______MODEL______COLOR______</p><p>LICENSE NUMBER______State______</p><p>LIST ADDITIONAL OPERATORS OF THE BOAT</p><p>NAME______RELATION______</p><p>ADDRESS & PHONE ______</p><p>PERSON TO CONTACT IN CASE OF EMERGENCY______</p><p>ADDRESS AND PHONE NUMBER______</p><p>HOW DID YOU FIND ABOUT THIS LOT? AD______DRIVING BY______FRIEND______</p><p>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 </p><p>______Signature Spouse </p><p>COMPANY USE ONLY:</p><p>VERIFIED BY ______DATE ______</p><p>APPROVED BY ______DATE______</p><p>APPROVAL GIVEN BY ______VERIFIED BY ______DATE ______</p><p>(4)</p>