Use your browser's print button to print out this application and submit to us via fax at 603-736-9505 or mail to:
MacCallum's Boathouse
P.O. Box 744
1049 Dover Road, Epsom, NH 03234

INDIVIDUAL   JOINT   RETAIL
PRIMARY APPLICANT
Last Name
First Name
Middle Initial
Date of Birth
Social Security #
Current Address
City
State/Zip		/
Phone Number
Years There
Previous Address
City
State/Zip		/
Years There
EMPLOYMENT HISTORY
Current Employer
Phone
Employers Address
City
State/Zip
Position
Years There
Gross Annual Income
Previous Employer
Position
Years There
REFERENCES
Nearest Friend or Relative (not living with you)
Address
City
State/Zip		/
Relationship
If you do not wish to rely upon income from alimony, child support or separate maintenance payments as a basis for repaying this obligation, such income need not be revealed.
Source of Additional Income
Gr. Mo. Inc.
Mortgage/Landlord
Own Rent Other
Monthly Pmt. (includ. Tax)
Balance
Estimated Value
Checking Account Bank
Savings Account Bank
CO-APPLICANT
If there is not a co-applicant applying please click here to continue.
Last Name
First Name
Middle Initial
Date of Birth
Social Security #
Current Address
City
State/Zip
Phone Number
Years There
Previous Address
City
State/Zip		/
Years There
CO-APPLICANT EMPLOYMENT HISTORY
Current Employer
Phone
Employers Address
City
State/Zip		/
Position
Years There
Gross Annual Income
Previous Employer
Position
Years There
CO-APPLICANT REFERENCES
Nearest Friend or Relative (not living with you)
Address
City
State/Zip		/
Relationship
If you do not wish to rely upon income from alimony, child support or separate maintenance payments as a basis for repaying this obligation, such income need not be revealed.
Source of Additional Income
Gr. Mo. Inc.
Mortgage/Landlord
Own Rent Other
Monthly Pmt. (includ. Tax)
Balance
Estimated Value
Checking Account Bank
Savings Account Bank
BELOW LIST CREDIT REFERENCES  (open or paid) including HOME EQUITY
Creditor Balance Payment Creditor Balance Payment
Do you have a boat to trade?		Yes No
If Yes, boat to trade year, make and model w/trailer:
Balance (if any) on boat to trade:
Boat to trade financed by:
Boat to trade loan number:
I am requesting a term of:		months
I'll be putting a cash deposit of:
Applicant Signature		x____________________________
Co-applicant Signature		x____________________________
By submitting this applicationto Maccallum's Boathouse and it's finance institutions, I/we certify that all information stated in the application is current to the best of my/our knowledge. I/we understand that you will retain this application whether or not it is approved. I/we authorize any creditor whom this application is forwarded to obtain any credit and employment history from any source, and to answer questions about it's credit/experience with me/us. It is also understood that MacCallum's Boathouse and it's financial institutions will safeguard, according to prudent security standards, the confidentiality of all non-public personal information provided.