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D.S.C.W. LLC rIM FINANCING APPLICATION
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Applications must be filled out completely. Incomplete Applications will be canceled
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First Name/Last Name
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Street Address
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City/State/ZipCode
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Renting/Buying or Other
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Monthly Rent or Payment
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Length of Residence
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*Fill out If less than 3 years on current address*
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Previous Street Address
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City/State/ZipCode
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Length of Residence
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Landlord, Apt or lender contact #
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Name of Apt, Lender, or Person
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Landlords Info.
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Work#
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Cell#
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Home#
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Phone#
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Email Address
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D.O.B
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SSN#
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Position
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Phone#
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Supervisor
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Name
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How long
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Employer Info.
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How Are You Paid? (Weekly, Bi Weekly, or Monthly)
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Monthly Net Income
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Bank Name
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Checking or Savings
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Bank Info.
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*Vehicle Information*
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Year/Make/Model
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Financing Company
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Monthly payment
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Applying for Wheels
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or Accessories
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What size Wheels?
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How did you hear about us?
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Google, Yahoo, Msn, Aol, Local listings, ect....
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Personal Reference Information
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City/State
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Home#
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Name
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Relationship
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1.
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2.
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3.
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4.
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By submitting this application, you are declaring that all information is true correct and
complete. You are also authorizing a representative from Down South Custom Wheels
LLC to contact you to discuss your application and product selection. This information
will be strictly confidential and will not be sold, shared or discussed with anyone outside
of the Down South Custom Wheels LLC organization and its affiliates.
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NOTE: CHARGES WILL APPLY FOR MOUNTING AND BALANCING WITH USE OF THE PROGRAM.
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