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387 Clifford Road, Selinsgrove, PA
570-374-2300
570-374-2300
www.salemrvsales.com
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Salem RV Center Financing Application
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*
Required field
Primary Applicant Information
First Name
*
Middle Name
*
Last Name
*
Date of Birth
*
(mm/dd/yyyy)
Social Security #
*
Driver's License #
*
# of Dependents
*
Primary Applicant Contact Details
Email
*
Contact Phone
*
Work Phone
Cell Phone
Address
*
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip/Postal
*
Years at Current Address
Do You Own or Rent?
Own
Rent
Monthly Payment
Financing Details
Which salesperson has been assisting you?
(ex: John Doe or none)
How much are you looking to finance?
(ex: $22,000 or unsure)
What type of RV are you interested in?
(travel trailer, fifth wheel, motorhome, not sure)
Primary Applicant Employment Information
Years at Employer
*
Employer Name
*
Occupation
*
Yearly Salary
*
(ex $50,000)
Other Income
*
Employer Phone
*
Employer Address Line 1
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip/Postal
*
Country
*
Add A Joint Applicant
Joint Applicant Contact Information
First Name
Middle Name
Last Name
Home Phone
Work Phone
Cell Phone
Email
Relation to Applicant
Date of Birth
Social Security Number
Driver's License #
# of Dependents
Joint Applicant Residency Information
Do you own or rent?
Own
Rent
Monthly Payment
Years at Address
Address Line 1
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip/Postal
Joint Applicant Employment Information
Years at Employer
Employer Name
Occupation
Yearly Salary
(ex $50,000)
Other Income
Employer Phone
Employer Address Line 1
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip/Postal
Country
Comments/Questions
By submitting this application, I/We certify that the submitted information is complete and accurate to the best of my/our knowledge. I/We understand and approve any inquiries regarding my/our credit record and employment history by the financial institution(s). I/We authorize the release of information about my/our credit experience.
It's ok to contact me about future discounts and events.
(Easily unsubscribe at any time.)