Northwest Harley-Davidson

Northwest Harley-Davidson offers all customers first-rate financing options. There is no charge or commitment to find out if you qualify for a bike.

CLICK HERE TO DOWNLOAD FINANCE APPLICATION.

Applicant Information

Applicants Full Name

Applicants Email Address

Social Security Number	Date of Birth


Current Physical Address

Address

City	State	Zip


Home Phone Number	How Long Have You Lived There?
$	Own Rent Other
Monthly Payment


Mailing Address (if different from physical address)

Address


City	State	Zip


Current Employer
Self Employed?
Name	Work Address (includes City, State and Zip)

	$
Work Phone	Gross Monthly Income	Current Title	Years There?

	$
Other Income Source*	Other Income Amount*
* Alimony, Child Support, and/or Separate Maintenance Income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Previous Employer (if less than 2 years at current employer)

Name	How Long There?

References

Relation	(1) Name

Home Phone Number	Address (include City, State and Zip)

Relation	(2) Name

Home Phone Number	Address (include City, State and Zip)

Relation	(3) Name

Home Phone Number	Address (include City, State and Zip)


Joint/Co-Signer Information
Applicant(s) must be at least 18 years old.

Joint/Co-Signer Applicant Full Name

Social Security Number	Date of Birth

Relationship


Current Physical Address

Address

City	State	Zip

Home Phone Number	How long have you lived there?
	Own Rent Other
Monthly Housing Payments


Current Employer
Self Employed?

Name	Work Phone

$
Gross Income Per Month	Position	How Long?

	$
Other Income Source*	Other Income Amount*
* Alimony, Child Support, and/or Separate Maintenance Income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Previous Employer (if less than 2 years at current employer)

Name	Address (includes City , State and Zip)

PURCHASE INFORMATION

Salesperson you've been working with at Northwest Harley-Davidson (if any)

Is this application for a: Northwest Harley-Davidson bike or a privately owned bike?

If buying private owned bike, what is selling price?:

What is the most you can pay down?

Do you have a trade in?

YES NO

Trade In:

YEAR:

MAKE:

MODEL:

Bike Wanted:

YEAR:

MAKE:

MODEL:

How did you hear about us?

Applicant Drivers License Number

Co-Applicant Drivers License Number

FINANCIAL PROTECTION PLAN (GAP) HAS BEEN PRESENTED AND I CHOOSE TO (check one)

Accept Decline this protection. Initials:

PAYMENT PROTECTION PLAN (CREDIT LIFE & DISABILITY) HAS BEEN PRESENTED AND I CHOOSE TO (check one)

Accept Decline this protection. Initials:

Coverage, rates and availability may vary by state. Dealer origination may affect the cost and terms of the offer. Credit approval is not based on your decision to accept or decline the coverage.

Check this box if you do not wish to share credit and employment experience and history as specified above.
Check this box if you do not wish to to authorize DataStat, Inc. to provide employment records to Harley-Davidson Credit Corp.
By typing your name below, you acknowledge that you have read the Notice to Applicant(s) section and agree to the terms and conditions set forth in this Customer Statement-Credit Application:
X
Applicants Name/Signature	Date
X
Co Applicants Name/Signature	Date

NOTICE TO APPLICANT(S):
This Customer Statement-Credit Application will be submitted to Harley-Davidson Credit Corp. at 4150 Technology Way, Carson City, Nevada 89706, for consideration as to whether it meets the credit requirements of Harley-Davidson Credit Corp.

I hereby authorize an investigation of my credit and employment history and the release of information about my credit experience with Harley-Davidson Credit Corp., and affiliates. I understand that, if my credit is approved by Harley-Davidson Credit Corp. and I wish to participate in any offers for products of Harley-Davidson Credit, and affiliates, my credit and employment history obtained in and in connection with this Customer Statement-Credit Application may be used in determining my eligibility for credit approval by Harley-Davidson Credit Corp., and affiliates.

If available, I authorize DataStat, Inc. to provide to Harley-Davidson Credit and to any potential investor or insurer of this credit transaction, state records of employment, including information reported by individual employers to the state, and income history, including State Employment Security Agency records. This authorization is for this credit transaction only and continues in effect for one (1) year unless limited by state law, in which case the authorization continues in effect for the maximum period, not to exceed one (1) year allowed by law. I understand that my refusal to consent shall not be the basis for the denial of credit and that my decision to disclose is voluntary and not required by law.

Vehicle insurance covering the collateral is required for the full term of the loan, at your expense, for liability and physical damage coverage for both collision and comprehensive losses to include