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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.