DEALER Name    ANGLER'S CHOICE

Contact Name      Nick

Fax Number    (276) 632-3423

Telephone Number    (276) 632-5600

APPLICAN T INFORMATION

NAME (First, Middle, Last)

Date of Birth

Social Security Number

Number of Dependents (Excluding Yourself)

ADDRESS         (Street)                                                         (City)                                               (State)                                     (Zip)

Telephone Number                    (            )

Time at address ______Yrs._______Mths

O Own  O Rent  O Live w/ Parents/Relative        O Other - Explain

Mortgage or Rent Payment $

Name and Address of Current Employer

Position

Time with Employer _______Yrs_______Mths

Business Phone                   (         )

Monthly Gross Income $

Other Monthly Income                                                                                                                                                                                                   $                                            Source

CO-APPLI CANT INFORMATION

NAME (First, Middle, Last)

Date of Birth

Social Security Number

 Home Phone Number                                (           )

ADDRESS         (Street)                                      (City)                                               (State)                                      (Zip)

Time at addre ss ______Yrs._______Mths

Monthly Gross Income $

Name and Address of Current Employer

Position

Time with Employer _______Yrs_______Mths

Business Phone                  (          )

DESCRIPTION OF GOO DS BEING PURCHASED

ITEM

New or Used

YEAR

MANUFACTURER

MODEL

BOAT

MOTOR

TRAILER

Sale Price&n bsp; $

Down Payment if any  $

Trade-in: Ye ar

Make:

Model:

I hereby aff irm that the foregoing information is true and correct and made for the purpose of obtaining credit. I authorize you to obtain additional information from each source(s) and each source is hereby authorized to provide you with such information. I also grant you permission to obtain a credit report on me for all legitimate purposes in connection with this transaction. Such purposes include assisting in making a credit decision, review ing my account and assisting in taking collection activity. I authorize you to share all the foregoing information with the Lender and it's subsidiaries. This application, in any event, shall be and remain the property of the Lender, and is subject to the completion and acceptance of additional credit application documents proper to any approved extension of credit.

________________________________________

________________________________________

Applicants Signature                                                     Date

Co-Applicants Signature                                                  Date