* Social Security #
* Date of Birth
* U.S. Citizen
* Years at Residence
* Work Phone
* Home Phone
* Mortgage Holder
Mortgage/Rent Payment *
* Annual Salary
* Length of
of Other Income
Previous employment required if less than 2 yrs at current employer.
* Sale price
* Loan Request
* Would you
like a yacht insurance quote?
* Years Boating
* How did
you find out about us?
Dealer/Broker (Please specify)
Boat Show (Please specify)
Magazine Ad (Please specify)
Other or specify:
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
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.
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.
ACT CUSTOMER IDENTIFICATION
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