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to support:
Authorized Dealer
Haulmark
CargoMate
Vintage
Diamond Cargo
Covered Wagon
NRC
Showhauler
Renegade

Credit Application

Type of credit requested: Individual Joint

Applicant
Personal Information

First Name
M.I.
Last Name
- -
Social Security Number 		/ /
Date Of Birth


Housing Information

Mailing Address (Include apt# if applicable)
City
State
Zip

Physical Address (if mailing is a P.O. box)
City
State
Zip
Housing Status:
 Own  Parents/Relative
 Rent  Other
Years at residence
Rent or Mortgage Amount 		- -
Home Phone


Employment Information

Employer
How Long (Yrs.)
Total Annual Income 		- -
Business Phone


Next Of Kin

First Name
M.I.
Last Name

Mailing Address (Include apt# if applicable)
City
State
Zip
- -
Home Phone


Joint Applicant
Personal Information

First Name
M.I.
Last Name
- -
Social Security Number 		/ /
Date Of Birth


Housing Information

Mailing Address (Include apt# if applicable)
City
State
Zip

Physical Address (if mailing is a P.O. box)
City
State
Zip
Housing Status:
 Own  Parents/Relative
 Rent  Other
Years at residence
Rent or Mortgage Amount 		- -
Home Phone


Employment Information

Employer
How Long (Yrs.)
Total Annual Income 		- -
Business Phone


Additional Information

E-Mail Address
Product Interested In

Best way and time to contact you
Additional Notes:



By submitting this application I grant Hickory Enclosed Trailer Sales, Inc. permission to try obtain a credit line for me. I also authorize Hickory Enclosed Trailer Sales, Inc. permission to contact me regarding this application.

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