Credit Application

Your new tractor

#00136

$22,000

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@dhmcotest.com. We look forward to earning your business!

* fields are required

Purchase #00136 - New 2024 TYM 2515H Tractor
Minimum to finance for tractors & tractor implements is $2500.00

Salesperson

Down Payment

Applicant

I have a co-applicant

First Name *

Middle Name

Last Name *

Social Security# *

Date of Birth *

Contacts

Home Phone *

Cell Phone *

Email *

County of the state you live in (not USA)*

Drivers License

Drivers License# *

Drivers License State *

Address

Physical Address *

City *

State *

Zip *

Mailing Address (if different)

City

State

Zip

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

Employment Type *

Company *

Occupation *

Work Phone *

Length of Employment *

years months

Primary Annual Income *

Additional Annual Income

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 *

Co-Applicant

First Name *

Middle Name

Last Name *

Social Security# *

Home Phone *

Cell Phone *

Email *

County of the state you live in (not USA)*

Date of Birth *

Drivers License# *

Drivers License State *

Physical Address *

City *

State *

Zip *

Mailing Address (if different)

City

State

Zip

Employment Type *

Company *

Length of Employment *

years months

Primary Annual Income *

Additional Annual Income

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.