* Required
Field
Personal
Information
Applicant
* Name
* E-Mail
* Social Security #
* Date of Birth
* Address
* U.S. Citizen
Yes
No
* City
* State
* Zip
* Years at Residence
* If you have been in your place of residence for LESS THAN TWO YEARS, please provide your previous address:
Street Address
City
State
Zip
* Work Phone
Cell Phone
* Home Phone
* RETIRED?
YES
NO
* Mortgage Holder
* Mortgage/Rent Payment
* Employment
* Position
* Annual Salary
* Length of
employment
Other Income/
Annually
Source
of Other Income
Previous employment required if less than 2 yrs at current employer.
* Purchase
Refinance
* Sale price
including tax
Price:
Tax:
Total:
* Loan Request
* Term
* Year
* Manufacturer
* Model
* Length
* Engine
Mfg.
* Number of Engines:
* Navigation
Area
* Mooring
Location
* HP Each
* Would you
like a yacht insurance quote?
Yes
No
* Current/Previous
Boat Description
* Years Boating
Experience
* Dealer/Broker of Private Party Purchase?
Choose
Dealer
Broker
Private Sale
* How did
you find out about us?
Choose
Previous customer
Friend
Internet Search - Google
Internet Search - Yahoo
Internet Search - Bing
Internet Search - The Hull Truth
Social Media - Facebook
Social Media - Instagram
Dealer/Broker (Please specify)
RV Show (Please specify)
Magazine Ad (Please specify)
Other
Other or specify:
Additional
Comments?
I/we acknowledge that I/we have made this application with
the intent that you should rely upon the information contained
herein in granting the credit requested. I/we understand
that, if the requested credit is granted, you may report
information concerning the credit to consumer reporting
agencies and to others. I/we affirm that my/our answers
are complete and true and authorize you to verify or obtain
any information concerning them. Upon your request, I/we
further authorize any firm or individual from whom I/we
may have obtained or requested credit, to furnish you with
the details of that transaction. I/we also agree to provide
current financial information upon request, in a form acceptable
to you.
If you wish to
submit this information on-line, click the "submit"
button at the bottom of the page. If you prefer to fax this
form, click print and fax it to 410-268-3755.
Note to
applicant: This prequalification is based purely on information
provided to us by you. Verification of this information
by us and additional information consisting of your last
two years federal tax returns including schedules A-E may
be required in order to issue an actual loan commitment.
Please fax them to: 410-268-3755.
PATRIOT
ACT CUSTOMER IDENTIFICATION
The
U.S. government, in order to fight the funding of terrorism
and money laundering, has issued a law requiring all financial
institutions to obtain, verify and record information
that identifies each person who opens an account. In addition
to the information on our application, please also provide
your drivers license number, issue and expiration date,
and the state that it was issued. We thank you for your
cooperation.