Credit Application

After filling out the application below, click on the SUBMIT button and the form will be sent to us via e-mail.  Please direct any questions you may have to sales@jimsmotors.com.
(* Required)

 Applications with the following conditions will not be considered by our finance companies.  If these conditions apply, please do not continue.
     - Beacon scores lower than 575
              - Bankruptcies discharged within the last 3 years
              - Non-US citizens
              - Non-US addresses
Please fill out the information below:
New  Used *Brand:
For Other--describe under Comments
Gooseneck   Bumper Pull
*# Horses/Stock : *Living Quarters :
*Approximate Cost:  
   
*Down Payment : Salesperson:
Comments: (Include trade-in information, options and trailer#(s) if not listed above.)

 
  Applicant      
  *First Name:
       
*Middle Name/Initial:
 *Last Name:
*Married or Single:
  
*Driver License Number:
 *Email Address:
*Date of Birth (mm/dd/yy)
 *Social Security Number: (Enter numbers only - no spaces or dashes)
*Address:

 
*City:
 *State:
 *Zip Code:
*Home Phone Number:
 Cell Phone Number:
*How long at residence?
 I prefer that you contact me by:
Previous Address (If less than 3 years at current residence):
 Years There:
*Own *Rent *Mortgage Holder or Landlord:
*Monthly Payment:
 *Balance:
*Employer: (Put retired or disabled if appropriate)
 *Work Phone Number:
*Occupation:
 *Length of Employment:
*Employers Address:
 *Years There:
Previous Employer (If less than 3 years with current employer):
*Have You Had Any judgments, foreclosures, or bankruptcies in the past 10 years? (Yes Or No):
 *Gross Pay per Year:
Other Income Source:
 Other Income Monthly Amount:
 
In the spaces below, please provide us with the names of two relatives who do not live with you. 
Relative 1:
*Name:
*Phone Number:
*Relationship:
  *Address:
 
*City:

*State:

*Zip Code:
     
Relative 2:    
*Name:

*Phone Number:
*Relationship:
    
*Address:
*City:

*State:

*Zip Code:

The same fields are required for the co-applicant as the primary applicant.
Leave all co-applicant fields blank if you have no co-applicant.
  Co-Applicant or Other Party
  First Name:
       
Middle Name/Initial:
 Last Name:
Driver License Number:
 Email Address:
Date of Birth (mm/dd/yy)
 Social Security Number: (Enter numbers only - no spaces or dashes)
Address:
  
City:
 State:
 Zip Code:
Home Phone Number:
How long at residence?
Previous Address (If less than 3 years at current residence):
 Years There:
 
Own Rent Mortgage Holder or Landlord:
Monthly Payment:
 Balance:
Employer:
 Work Phone Number:
Occupation:
 Length of Employment:
Employers Address:
 Years There:
Have You Had Any judgments, foreclosures, or bankruptcies in the past 10 years? (Yes Or No):
  
Previous Employer (If less than 3 years with current employer):
 Years There:
Gross Monthly Income:
Other Income per Year:
 Source of Other Income:
 

In the space below, please provide us with the names of two relatives who do not live with you. 
Relative 1:
Name:
Phone Number:
Relationship:
Address:
 
City:

State:

Zip Code:
     
Relative 2:
Name:
 Phone Number:
Relationship:
    
Address:
City:

State:

Zip Code:
     
 

 
If you have any questions or concerns, please contact us.
1-800-897-9840
sales@jimsmotors.com
Your IP Address is: 184.72.184.104
1-800-897-9840
Jims Motors
I - 44 & Ozark Dr.
Cuba, MO  65453
www.jimsmotors.com   sales@jimsmotors.com
 
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