FULL NAMEDATE

ADDRESS  HOW LONGYR

CITY, ST., ZIP

LESS  5YR  HOW LONGYR

PHONE       CELL UNMARRIED

BIRTHDAY  SSI # MARRIED

DRIVERS LICENSE # BANK

WORK        PHONE

INCOME/MONTH   

ADDRESSHOW LONGYR

CITY, ST. ZIP

PREVIOUS WORKHOW LONGYR

ANY OTHER INCOME

BANKRUPTCY IN THE LAST 3YRS     REPOSSESSION    

PERSONAL REF.PHONE

BUYING ITEM       DOWN PAY 

YOU ARE GIVING R&M MARINE INC./ BOAT SALES, PERMISSION TO RUN YOUR CREDIT, AT A OUT SOURCED AGENCY, WE HOLD NO LIABILITY FOR THIS TRANSACTION. CLICK THIS BUTTON FOR AUTHORIZATION.