Dragoon's Farm Equipment
Credit Inquiry Form
NOTE: If you would like a joint application you will add the 2nd borrower's information at the bottom of this form.
Have you been working with a Sales Representative?
Yes, Dan Dragoon
Yes, Ryan Dragoon
Yes, Jordon Keleher
Not Sure
No, I have not worked with anyone
Name
*
First Name
Middle Name
Last Name
Suffix
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How Long have you lived at this address?
*
Housing Status
*
Own/Buying
Rent Free
Rent
Other
Monthly housing / rent payment $
*
Applicant Inforamtion
*
Consumer/personal/household use
Business/commercial use
Individual or Business Type
Corporation
LLC
LLP
Partnership
Municipality
Birth Date
*
Social Security Number
*
State Issued Driver's License Number
*
Driver's License Expiration Date
*
What state issued your driver's license?
*
Are you tax-exempt? (Note you will be required to supply the correct form before sale is complete)
*
Yes
No
I don't know
Personal Reference Name
*
First Name
Last Name
Personal Reference Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Personal Reference Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employment Information
Current Employer (If self employed, business name)
*
Position/Title
*
Type of Business
*
Business Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Employer Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have worked for this employer?
*
Gross Monthly Income From All Sources
*
Equipment
What piece of equipment are you interested in?
*
Do you have a trade-in?
*
Yes
No
Maybe
Year of Trade-In
Make & Model
Hours
Condition
Will you be providing a down payment, if so how much?
Signature
*
Add Joint Application Information Here
Would you like a joint application?
Yes
No
Joint Application
First Name
Middle Name
Last Name
Suffix
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How Long have you lived at this address?
Housing Status
Own/Buying
Rent Free
Rent
Other
Monthly housing / rent payment $
Social Security Number
State Issued Driver's License Number
Driver's License Expiration Date
What state issued your driver's license?
Date of Birth
Employment Information
Current Employer (If self employed, business name)
Position/Title?
Type of Business
Business Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you worked for this employer?
Gross Monthly Income From All Sources
Signature
Email
example@example.com
Please add a photo of the driver's license for all applicants.
*
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