Bayer RV Financing Application

18417 South US Hwy 377, Dublin, TX 76446
Phone: 800-859-9205

Fax: 254-445-4837

 Primary Applicant Information 
Your Information Is Secure padlock
First Name: *required
Last Name: *required
Email: (name@email.com) *required
Contact Phone: (555-555-1212) *required
Address: *required
City: *required
State: *required
Zip/Postal: (48258) *required
 Other Primary Applicant Information 
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)
Work Phone: (555-555-1214)
Cell Phone: (555-555-1215)
Years at Current Address:
Do You Own or Rent?:       Monthly Payment:
Date of Birth: (mm/dd/yyyy) *required
Middle Name: *required
Social Security Number: (555-55-5555) *required
Driver's License #: *required
# of Dependents: *required
 Primary Applicant Employment Information 
Years at Employer: *required
Employer Name: *required
Occupation: *required
Yearly Salary: (ex $50,000) *required
Other Income: (ex $10,000) *required
Employer Phone: *required
Employer Address Line 1: *required
Address Line 2:
City/State/Postal Code: *required
Country: *required
 Joint Applicant Contact Information 
First/MI/Last:
Home Phone: (555-555-1287)
Work Phone: (555-555-1288)
Cell Phone: (555-555-1289)
Email: (user@domain.com)
Relation to Applicant:
Date of Birth: (mm/dd/yyyy)
Social Security Number: (555-55-5555)
Driver's License #:
# of Dependents:
 Joint Applicant Residency Information 
Do You Own or Rent:       Monthly Payment:
Years at Address:
Address Line 1:
Address Line 2:
City/State/Postal Code:
 Joint Applicant Employment Information 
Years at Employer:
Employer Name:
Occupation:
Yearly Salary: (ex $50,000)
Other Income: (ex $10,000)
Employer Phone:
Employer Address Line 1:
Address Line 2:
City/State/Postal Code:
Country:
Comments/Questions:
 
*required 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.