Credit Application

Your new implement

#00095

$6,500

Please fill out this application completely. Any missing or incorrect information may prevent your application from being processed or cause delays.

If you have any questions, please call 877-694-5665 ext. 127 or email finance@dhmco.com. We look forward to earning your business!

* fields are required

Step 1 - Trade In & Down Payment
Purchase Info

Salesperson:

Down Payment:

No Down Payment

Trade-In

I be trading in another Trailer or Vehicle

What do price you expect to get for your trade-in?

Trade-in Year

Trade-in Manufacturer

Trade-in Model

Describe your Trade-in:

Trade-in Title:

Lienholder:

Amount Owed on Trade-in:

If you have not yet discussed your trade-in with your salesperson, send pictures of your trade-in and a copy of your title (if in your possession) to info@dhmco.com or use our Trade-In Form.
Please fix these errors before going to the next page:
Step 2 - Applicant
Notes:
- Enter your legal name as it appears on your drivers license.
- Do not combine your income with your spouse's income. If your spouse is the co-applicant, enter your spouse's income on the Co-Applicant section of this form.
First Name *

Middle Name

Last Name *

Social Security # *

Date of Birth *

Drivers License

Drivers License# *

State *

Drivers License Expiration Date *

Contacts

Home Phone *

Cell Phone *

Email *

Preferred Contact *

Physical Address

Street *

City *

State *

Zip Code *

County/Parish *

Mailing Address Click if same as Physical Address

Street

City

State

Zip Code

Address on Drivers License (if different from mailing/physical address)

Street

City

State

Zip Code

Residence
If your home is paid for, enter $0 for Payment and "N/A" for Payee

How long have you lived at your current residence? *
years months

Previous Address (if less than 2 years at current)

Own/Rent *

Payment *

Payee *

Employment

Type *

Company *

Occupation *

Work Phone *

Length of Employment *
years months

Previous Employer (if less than 2 years at current)

Annual Gross Pay *

Other Income

Amount (Annual)

Source

How Long

References
Relatives, friends, co-workers, or acquaintances who do not live with you and are not applying for credit

Name *

Phone *

Relationship *

Name *

Phone *

Relationship *
Please fix these errors before going to the next page:
Step 3 - Co-Applicant
I have a co-applicant
ACKNOWLEDGMENT BY CO-APPLICANT: By providing Co-Applicant information, you confirm your intent to apply for joint credit and be jointly liable for the debt.
- the Co-Applicant's legal name as is appears on their drivers license
- Do not combine your income with your spouse's income. If your spouse is the co-applicant, enter your spouse's income on the Co-Applicant section of this form.
First *

Middle

Last *

Social Security # *

Date of Birth *

Drivers License

Drivers License# *

State *

License Expiration Date *

Contacts

Home Phone *

Cell Phone *

Email *

Physical Address

Street *

City *

State *

Zip Code *

County/Parish *

Mailing Address Click if same as Physical Address

Street

City

State

Zip Code

Address on Drivers License (if different from mailing/physical address)

Street

City

State

Zip Code

Residence

How long have you lived at your current residence? *
years months

Previous Address (if less than 2 years at current)

Own/Rent *

Payment *

Payee *

Employment

Type *

Company *

Occupation *

Work Phone *

Length of Employment *
years months

Previous Employer (if less than 2 years at current)

Annual Gross Pay *

Other Income

Amount (Annual)

Source

How Long

References
Relatives, friends, co-workers, or acquaintances who do not live with you and are not applying for credit

Name *

Phone *

Relationship *

Name *

Phone *

Relationship *
Please fix these errors before going to the next page:
Step 4 - Authorization
I/we authorize Dixie Trailer Works, Inc. to access my/our consumer credit report(s).

By electronically signing below you authorize Dixie Trailer Works, Inc. to access your consumer credit report. (Type your name below to signify your authorization.)

Primary Applicant:

Co-Applicant:

By your act of submitting this credit application to Dixie Trailer Works, Inc., you are certifying and attesting to the fact that the information contained herein is, in fact, your own personal information, and that you are, in fact, the person the information herein contained describes. You are authorizing us to share this information with potential lenders. You are authorizing us and potential lenders to check your credit report and employment history.
Please fix these errors before clicking Submit:

Credit Application

Purchase Info

Trade-In

Please fix these errors before going to the next page:

Drivers License

Contacts

Physical Address

Mailing Address Click if same as Physical Address

Address on Drivers License (if different from mailing/physical address)

Residence If your home is paid for, enter $0 for Payment and "N/A" for Payee

Employment

Other Income

References Relatives, friends, co-workers, or acquaintances who do not live with you and are not applying for credit

Please fix these errors before going to the next page:

Drivers License

Contacts

Physical Address

Mailing Address Click if same as Physical Address

Address on Drivers License (if different from mailing/physical address)

Residence

Employment

Other Income

References Relatives, friends, co-workers, or acquaintances who do not live with you and are not applying for credit

Please fix these errors before going to the next page:

Please fix these errors before clicking Submit:

Residence
If your home is paid for, enter $0 for Payment and "N/A" for Payee

References
Relatives, friends, co-workers, or acquaintances who do not live with you and are not applying for credit

References
Relatives, friends, co-workers, or acquaintances who do not live with you and are not applying for credit