CONTACT:   Dennis Grossenbacher

Phone: (616) 498-9768  Fax: (616) 837-7165

  BUYER
First Name Last Name
Street Address City Name
State/Province                                            Zip/Postal Code
Daytime Phone Date of Birth
Social Security # Drivers License. #
Employer's Name Work Phone #
Time on Job (Yrs) Salary (Annual)
Source of Other Income Amount (per Month) $
  CO-BUYER
Co-Buyer First Name Co-Buyer Last Name
Co-Buyer Street Address Co-Buyer City Name
Co-Buyer State/Province                    Co-Buyer Zip/Postal Code
Co-Buyer Daytime Phone Co-Buyer Date of Birth
Co-Buyer Social Security # Co-Buyer Drivers License. #
Co-Buyer Employer's Name Co-Buyer Work Phone #
Co-Buyer Time on Job (Yrs) Co-Buyer Salary (Annual)
Co-Buyer Source of Other Income Co-Buyer Amount (per Month) $
  UNIT INFORMATION
Make        Model             
Checking this box and submitting this application, I/We Certify that the above information is true and complete to the best of my/our knowledge and I/we authorize Fun-N-suN RV, Inc. to have my/our credit and employment history checked.  
Applicant Signature Co Applicant Signature