Top Quality Motors Credit Application
Print this application, fill it out and bring to Top Quality Motors, 1111 Central Avenue NW, East Grand Forks, MN  
or Fax the completed form to us at 1-218-773-0536

Amount Requested: ________  How Long: _______  Payment Date Desired:________ Repay Monthly/Other: __________
Proceeds to be used for: _______________________________________________Sales Person: ___________________
Applicant Information
Last Name: ________________________________  First Name: ______________________Middle:_________ DOB:______________
Social Security #: ____________________________Telephone #_________________________Cell #_________________________
Address___________________________________  City:_____________State_______ ZIp____________# of Dependents ________  Ages of Dependents: ___________________________________   Rent or Own?_____________Years at  Address:_______________
Previous Address if Less Than 3 Years____________________________________________________________________________
Employer__________________________________________________  Supervisor________________________________________
Your Title ___________________________Gross or Net Income/Month________________ Phone:___________________________
Employer Address____________________________________________________________________________________________  
Previous Employer if Less Than 3 Years __________________________________________________________________________
2nd Employer, if Applicable_____________________________________________________________________________________
Any Other Sources of Income Not Listed Above: ____________________________________________________________________
Co-Applicant Information

Last Name: ________________________________  First Name: ______________________Middle:_________ DOB:______________
Social Security #: ____________________________Telephone #_________________________Cell #_________________________
Address___________________________________  City:_____________State_______ ZIp____________# of Dependents ________  Ages of Dependents: ___________________________________   Rent or Own?_____________Years at  Address:_______________
Previous Address if Less Than 3 Years____________________________________________________________________________
Employer__________________________________________________  Supervisor________________________________________
Your Title ___________________________Gross or Net Income/Month________________ Phone:___________________________
Employer Address____________________________________________________________________________________________  
Previous Employer if Less Than 3 Years __________________________________________________________________________
2nd Employer, if Applicable_____________________________________________________________________________________
Any Other Sources of Income Not Listed Above: ____________________________________________________________________
Assets Owned
Checking Account #’s & Where ________________________________________________________ Average Balance____________
Savings Account #’s & Where _________________________________________________________ Average Balance____________ Certificates of Deposit  & Where _______________________________________________________ Average Balance____________
Real Estate: _____________________________________________Subject to Debt: _______________ Value:___________________
Autos (Make, Model & Years): _______________________________Subject to Debt:_______________ Value:___________________
_______________________________________________________Subject to Debt:_______________ Value:___________________
Other Assets____________________________________________ Subject to Debt:_______________ Value:___________________
Outstanding Debts (Include charge accounts,installment contracts, credit cards, rent, mortgages & other obligations)
Land/Mortgage Holder _______________________Original Amt:__________Current Balance_________ Monthly Payment _________
Vehicles: __________________________________Original Amt: __________Current Balance_________ Monthly Payment _________
__________________________________________Original Amt:__________Current Balance_________ Monthly Payment _________
Credit Cards________________________________Original Amt: __________Current Balance_________ Monthly Payment _________
__________________________________________Original Amt:__________Current Balance_________ Monthly Payment _________
Other Debts: _________________________________________________________________________________________________
___________________________________________________________________________________________________________
Are you obligated to make alimony, support or maintenance payments?  ______ To Whom? __________Monthly Pmt_____________
Are you co-maker, endorser or guarantor on any loan or contract?  ______ To Whom? ______________Monthly Pmt_____________
Are there any unsatisfied judgements against you?______________  If so, to whom?________________Amount:________________
Have you declared bankruptcy in the last 10 years?  ___________If yes, where? _____________________Year_________________

Signature of Applicant_________________________________________________________  Date___________________________

Signature of  Co-Applicant______________________________________________________  Date___________________________