Polaris Medina Online Finance Application

Online Finance Application

Apply for financing using our secure online finance application. Start by entering details of the model you are interested in and whether you are applying for an individual application or jointly with a co-applicant
Source
Unit Stock #, Make or Model*
Loan Type*

IndividualJoint
Finance Request
Down Payment*
Finance Amount Requested*
Price of Unit to Finance*
Term of Loan*
Enter Applicant Information
Full Name*

First NameMiddle NameLast Name
E-mail*

Confirmation Email
Phone Number*
Box Name
Permission to Retreive Credit History

Applicant Personal Details
Date of Birth
Please enter date as shown: e.g. 01/02/1990
Social Security Number*
Drivers License Number*
Drivers License Expiration*
Marital Status*
Applicant Current Address Information
Current Address*

Street Address

Street Address Line 2

CityState

Zip Code
Residential Status*
How Long Have You Lived at this Address *
Please enter specifically such as total time in weeks, months, or years
Monthly Payment Amount*
Example: $900.00
Name of Landlord or Mortgage Holder*
Applicant Previous Address Information
Have You Lived at a Previous Address?*

YesNo
How Long did you live at this Address?*
Please enter specifically such as total time in weeks, months, or years
Previous Address*

Street Address

Street Address Line 2

CityState

Zip Code

Applicant Current Employment Information
Employer Name*
Occupation*
How Long Have You Worked at This Employer?*
Please enter specifically such as total time in weeks, months, or years
Yearly Income Amount*
Example: $45,000.00
Work Phone Number*
Applicant Previous Employment Information
Have You Worked at a Previous Place of Employment*

YesNo
Previous Employer Name*
Previous Occupation*
How Long Did You Work at this Employer?
Please enter specifically such as total time in weeks, months, or years
Yearly Income Amount*
Example: $45,000.00
Previous Work Phone Number*
Applicant Additional Income

Alimony, child support or seperate maintenance income need not be revealed if you not wish to have it considered as a basis for repaying this debt.
Do You Have An Additional Income Sources?*

YesNo

Co-Applicant Personal Information
Co-Applicant Birth Date*
MM/DD/YYYY
Co-Applicant Social Security Number*
Co-Applicant Drivers License Number*
Co-Applicant Drivers License Expiration Date*
MM/DD/YYYY
Co-Applicant Marital Status*
Co-Applicant Phone Number*
Co-Applicant Current Address Information
Co-Applicant Current Address*

Street Address

Street Address Line 2

CityState

Zip Code
Co-Applicant Residential Status*
How Long Has The Co-Applicant Lived at this Address*
Please enter specifically such as total time in weeks, months, or years
Monthly Payment Amount*
Example: $900.00
Name of Landlord or Mortgage Holder*

Co-Applicant Previous Address Information
Has the Co-Applicant Lived at Another Address?*

YesNo
How Long did the Co-Applicant Live at this Address?*
Please enter specifically such as total time in weeks, months, or years
Co-Applicant Previous Address*

Street Address

Street Address Line 2

CityState

Zip Code
Previous Address Monthly Payment Amount*
Example: $900.00
Co-Applicant Current Employment Information
Co-Applicant Employer Name*
Co-Applicant Occupation*
Co-Applicant Work Phone Number*
How Long Has The Co-Applicant Worked at this Employer?
Please enter specifically such as total time in weeks, months, or years
Yearly Income Amount*
Example: $45,000.00

Co-Applicant Previous Employment Information
Has The Co-Applicant Worked at a Previous Place of Employment*

YesNo
Co-Applicant Previous Employer Name*
Co-Applicant Previous Occupation*
Co-Applicant Previous Work Phone Number*
How Long did the Co-Applicant work at this Employer?*
Please enter specifically such as total time in weeks, months, or years
Yearly Income Amount*
Example: $45,000.00
Co-Applicant Additional Income

Alimony, child support or seperate maintenance income need not be revealed if you not wish to have it considered as a basis for repaying this debt.
Do You Have An Additional Income Sources?*

YesNo

Review Application Details

Please review your Finance Application details below - If everything looks correct, press the submit button to complete the application.
Should be Empty:

Online Finance Application