Online Credit Application for Ben's RV Center
1590 Whiteford Rd, York, PA 17402. Phone: 717-755-9669. Fax: 717-340-4244
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Are you applying jointly with another individual?
Do you know which unit you are interested in purchasing?
Do you have a unit that you will be trading in?
Do you currently have an insurance provider for the desired collateral type?
Personal Information
Please enter the personal information for the primary applicant. All bold * fields are required.
- Current Residence
Please enter the current residence information for . This must be the physical address where resides. If has a separate mailing address, you can select that option separately. All bold * fields are required.
years months
$
Is your mailing address different than your current/physical address?
- Previous Residence
Most lenders require previous residence information if an applicant has not lived at their current residence for over 2 years. Since meets this criteria, please enter the previous residence information for . All bold * fields are required.
years months
- Current Employment
Please enter the current employment information for . All bold * fields are required.
$
years months
Does have a secondary job/employment with a minimum of 1 year tenure?
Does have any other sources of income? (e.g. Alimony, Child Support, etc.)

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

- Secondary Employment
Please enter the secondary employment information for . All bold * fields are required.
$
years months
- Previous Employment
Most lenders require previous employment information if an applicant has not worked at their current job for over 2 years. Since meets this criteria, please enter the previous employment information for . All bold * fields are required.
$
years months
- Other Income
Please enter any other sources of income for . All bold * fields are required.
$

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Personal Information
Please enter the personal information for the secondary applicant. All bold * fields are required.
- Current Residence
Please enter the current residence information for . This must be the physical address where resides. If has a separate mailing address, you can select that option separately. All bold * fields are required.


years months
$
Is your mailing address different than your current/physical address?
- Previous Residence
Most lenders require previous residence information if an applicant has not lived at their current residence for over 2 years. Since meets this criteria, please enter the previous residence information for . All bold * fields are required.
years months
- Current Employment
Please enter the current employment information for . All bold * fields are required.
$
years months
Does have a secondary job/employment with a minimum of 1 year tenure?
Does have any other sources of income? (e.g. Alimony, Child Support, etc.)

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

- Secondary Employment
Please enter the secondary employment information for . All bold * fields are required.
$
years months
- Previous Employment
Most lenders require previous employment information if an applicant has not worked at their current job for over 2 years. Since meets this criteria, please enter the previous employment information for . All bold * fields are required.
$
years months
- Other Income
Please enter any other sources of income for . All bold * fields are required.
$

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Desired Unit
Please enter the information for the unit you are looking to purchase and finance below. All bold * fields are required.
Boat/Hull Info Add
Motor Info Add
Trailer Info Add
Please enter the information for the unit you are looking to trade in below. All bold* fields are required.
$
Please enter the information for the unit you are looking to trade in below. All bold* fields are required.
$
Insurance Information
Please enter the insurance information for the primary applicant. All bold* fields are required.
$
Personal References (Optional)
Please enter personal reference inforamtion below.
Personal Reference #1
Personal Reference #2
Primary Applicant
Name:
Date of Birth:
SSN:
Current Residence:
Mailing Address:
Previous Residence:
Current Employment:
Secondary Employment:
Previous Employment:
Other Income: ()
Secondary Applicant
Name:
Date of Birth:
SSN:
Current Residence:
Mailing Address:
Previous Residence:
Current Employment:
Secondary Employment:
Previous Employment:
Other Income: ()
Collateral
Trade-In
Insurance Information
Insurance Carrier Company Name:
Policy #:
Agent Name:
Agent Phone Number:
Deductible:
Personal References
None
Name:
Relationship:
Phone:
Name:
Relationship:
Phone:
Payment Information (optional)
$
$
Notice to Residents
Legal Disclosure
You agree that your telephone communications with us and any financial company that reviews this credit application may be monitored and/or recorded to assure the quality of service. You give your consent to receive calls and text messages from the creditor or its third party debt collector at any number you have given us in this credit application or in the future; including calls and messages made using an auto dialer or prerecorded message, even if the telephone number is a cell phone number or other wireless device and the contact or message results in a charge to you. You agree that we can send disclosures or other communications to you electronically at the e-mail address you have given us.

IMPORTANT APPLICANT INFORMATION: Federal law requires financial companies to obtain sufficient information to verify your identity. You may be asked several questions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information.
By entering your name below & submitting this application, you certify that the information provided on the application is, to the best of your knowledge, complete and accurate. You agree to provide your electronic signature, acknowledge receipt of any Disclosures and agree to the E-SIGN CONSENT. By submitting this credit application you understand that we and the financial institution(s) will rely on this information to judge your credit worthiness, and will retain this application and information about you whether or not this application is approved.

Further, you authorize an investigation of your credit and employment history, which will include obtaining credit report(s) from one or more consumer credit reporting agencies. You further understand that we and/or the financial institution(s) that evaluate your application may require additional information. You agree that you will accept disclosures or other communications electronically at the e-mail address you have given us. You agree that we or any financial institution(s) that review this credit application may call or text you at the phone number you have given us in this application.

You understand that false statements may subject you to criminal penalties.

Upon successful submission of this application, you will receive an email with a link to download a copy of the completed credit application for your records. If you do not wish to electronically sign & submit this application online, you may print the credit application (by clicking on the printer icon above) and manually sign and submit it off-line.