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TRIAD MANUFACTURED HOME CREDIT APPLICATION

PLEASE MAKE SURE YOU PRINT THIS APPLICATION BEFORE YOU SUBMIT IT!

IF YOU FORGET, YOU CAN ALWAYS HIT THE BACK ARROW BUTTON TO SEE YOUR DATA.

ALSO, IF YOU INCLUDE AN EMAIL ADDRESS WE WILL EMAIL YOU A RECEIPT NOTIFICATION.

THIS APPLICATION IS DESIGNED TO BE COMPLETED BY THE APPLICANT. YOU MAY APPLY FOR CREDIT EITHER INDIVIDUALLY OR JOINTLY WITH A CO-APPLICANT.

INDIVIDUAL: If you are applying for individual credit in your own name and are relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit  requested, complete Section 2.

JOINT: If this is an application for joint credit with another person, complete all sections, providing information in Section 3 about the co-applicant.

SECTION 1: DEALER INFORMATION
RETAILER TRIAD DEALER No. LOCATION CITY STATE ZIP
SALES PERSON PHONE FAX e-MAIL ADDRESS
DO YOU HAVE A BROKER'S FEE? YES NO IIF YES, WHAT IS THE BROKER'S FEE AMOUNT:
 

SECTION 2: APPLICANT
PERSONAL INFORMATION
FIRST NAME MI LAST NAME

SOC. SEC. No

 BIRTH DATE mm dd yyyy

HOME PHONE DRIVER'S LICENSE No STATE ISSUE DATE mm dd yyyy EXPIRES mm dd yyyy
MARITAL STATUS NUMBER OF DEPENDENT CHILDREN AGES

PRESENT STREET ADDRESS (No P.O. Boxes) CITY STATE ZIP

TIME AT PRESENT ADDRESS

 PAYMENT TYPE

MONTHLY PAYMENT

   ARE YOU SELLING YOUR CURRENT HOME?

YRS  MOS

$

 YES

NO
PREVIOUS  STREET ADDRESS (IF LESS THAN 2 YEARS AT PRESENT) CITY STATE ZIP
       
EMPLOYMENT AND INCOME INFORMATION
CURRENT EMPLOYER CITY STATE PHONE NUMBER
JOB TITLE HIRE DATE mm dd yyyy GROSS SALARY PER
$
PREVIOUS EMPLOYER CITY STATE PHONE NUMBER
JOB TITLE

EMPLOYED mm/yy
FROM       TO

NOTE: Alimony, child support, or separate income does not need to be revealed unless you want it considered for repayment of this obligation.
OTHER INCOME SOURCE MONTHLY AMOUNT
$
CREDIT  INFORMATION CHECKING SAVINGS
BANK REFERENCE

OBLIGATIONS INFORMATION

PAYMENT TYPE

 LANDLORD OR MORTGAGE HOLDER NAME

PHONE NUMBER

 CURRENT BALANCE MONTHLY PAYMENT

$ $
LARGEST OTHER OBLIGATION

PHONE NUMBER

 CURRENT BALANCE MONTHLY PAYMENT
$ $
ALIMONY / CHILD SUPPORT MAINTENANCE PAYMENT CURRENT BALANCE MONTHLY PAYMENT
$ $

I hereby declare that all of the statements made are true and correct. For the purpose of obtaining credit, the creditor is authorized to investigate my credit record, to obtain a credit report, to verify my credit, employment and income reference, to obtain such other information as the creditor deems necessary and to give credit reporting agencies (credit bureaus) and others information regarding the creditor's credit experience with me.
 
APPLICANT'S SIGNATURE SIGNATURE ON FILE? DATE mm/dd/yyyy
YES         NO 

SECTION 3: CO-APPLICANT
PERSONAL INFORMATION
FIRST NAME MI LAST NAME

SOC. SEC. No

 BIRTH DATE mm dd yyyy

HOME PHONE DRIVER'S LICENSE No STATE ISSUE DATE mm dd yyyy EXPIRES mm dd yyyy
MARITAL STATUS NUMBER OF DEPENDENT CHILDREN AGES

PRESENT STREET ADDRESS (No P.O. Boxes) CITY STATE ZIP

TIME AT PRESENT ADDRESS

 PAYMENT TYPE

MONTHLY PAYMENT

   ARE YOU SELLING YOUR CURRENT HOME?

YRS  MOS

$

 YES

NO
PREVIOUS  STREET ADDRESS (IF LESS THAN 2 YEARS AT PRESENT) CITY STATE ZIP
EMPLOYMENT AND INCOME INFORMATION
CURRENT EMPLOYER CITY STATE PHONE NUMBER
JOB TITLE HIRE DATE mm dd yyyy GROSS SALARY PER
$
PREVIOUS EMPLOYER CITY STATE PHONE NUMBER
JOB TITLE

EMPLOYED mm/yy
FROM       TO
NOTE: Alimony, child support, or separate income does not need to be revealed unless you want it considered for repayment of this obligation.
OTHER INCOME SOURCE MONTHLY AMOUNT
$

I hereby declare that all of the statements made are true and correct. For the purpose of obtaining credit, the creditor is authorized to investigate my credit record, to obtain a credit report, to verify my credit, employment and income reference, to obtain such other information as the creditor deems necessary and to give credit reporting agencies (credit bureaus) and others information regarding the creditor's credit experience with me.
 
CO-APPLICANT'S SIGNATURE SIGNATURE ON FILE? DATE mm/dd/yyyy
YES         NO 

SECTION 4: MANUFACTURED HOME INFORMATION
MANUFACTURER (MAKE) MODEL YEAR WIDTH LENGTH
NEW USED THIS HOME WILL BE YOUR: MANUFACTURED HOME PLACEMENT LAND OR LOT PAYMENT
$
PROPERTY STREET ADDRESS CITY STATE ZIP

SECTION 5: LOAN TYPE INFORMATION
LOAN PURPOSE IF REFI,
LOAN TYPE

FINANCING OPTIONS: (Land / Home ONLY)

 TERM RATE PAYMENTS FLOOR PLAN POINTS
MOS % $ #

SECTION 6: SALES INFORMATION
1 CASH SALE PRICE $ 11

TRADE-IN DOWN PAYMENT

 13 OPTIONS
2a SALES TAX $ 11a
MANUFACTURER YEAR
13a AIR CONDITIONER $
2b TAG / TITLE $ 11b
MODEL SIZE
WL
13b WASHER / DRYER $
3 CASH SALE PRICE WITH TAX, TAG & TITLE $ 11c
TRADE-IN PAYOFF TO
13c SKIRTING $
4a GROSS TRADE-IN $ 11d DOWN PAYMENT -  WAS ANY BORROWED OR GIFTED? 13d STEPS $
4b LESS AMOUNT OWED $  
YES NO
13e OTHER $
4c NET TRADE-IN $ 11e
IF YES, HOW MUCH?
$
13f OTHER $
5 CASH DOWN PAYMENT $ 11f
IF YES, WHERE WAS IT OBTAINED?
13g TOTAL OPTIONS $
6 TOTAL DOWN PAYMENT $ 112

HOME INFORMATION

 14 SET-UP /DELIVERY $
7 INSURANCE $ 12a MANUFACTURER'S INVOICE $ 15 TAXES, TAG, TITLE FEES $
8 SUBTOTAL $ 12b DELETION $ 16 INSURANCE $
9 BUY DOWN POINTS $ 12c NET INVOICE $ 17 BUY DOWN POINTS $
10 AMOUNT TO FINANCE $ 12d % OF MFG. INVOICE $ 18 MAXIMUM ALLOWABLE ADVANCE $

SECTION 7: INFORMATION FOR GOVERNMENT MONITORING PURPOSES

The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing, and home mortgage disclosures laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may discriminate neither on the basis of this information, nor on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation or surname. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.)

APPLICANT 

CO-APPLICANT 

I DO NOT WISH TO FURNISH THIS INFORMATION   I DO NOT WISH TO FURNISH THIS INFORMATION
ETHNICITY     ETHNICITY  
RACE  American Indian or Alaska Native  Asian  White
(You may choose more than one)
Native Hawaiian or Other Pacific Islander Black / African American
 
RACE  American Indian or Alaska Native  Asian  White
(You may choose more than one)
Native Hawaiian or Other Pacific Islander Black / African American
SEX            SEX           
To be completed by the interviewer (retailer). The application was taken by:    
SECTION 8: DEALER COMMENTS
IMPORTANT!  To keep a copy of this application for your records, please print this page before you hit the Submit Application button.
 

Midwest Regional Office:
Triad Financial Services, Inc.
125 Mooney Drive Suite 1
Bourbonnais, IL 60914
Phone: 888-936-1179 Fax: 888-936-1290		 Home Office:
Triad Financial Services, Inc.
4336 Pablo Oaks Court
Jacksonville, FL 32224
Phone: 800-522-2013 Fax: 888-733-1522		 Southwest Regional Office:
Triad Financial Services, Inc.
15333 JFK Boulevard    Suite 160
Houston, TX 77032
Phone: 281-219-0681 Fax: 281-219-0682