1046 N US 1
Ormond Beach, FL 32174
386-547-3180
Site Menu
Inventory
Motorcycles
Apply Online
Visit Our Store
Services
Customizations
Parts & Accessories
Transportation/Shipping
APPLY FOR CREDIT
For Approval you must enter
2 years employment history and residence history
If you rent are renting please enter your landlords information in the
Additional Comments
field.
If you have have a
voluntary turn in, auto charge off or repossession
please explain in the
Additional Comments
field at the bottom of the form.
Applicant Information
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Social Security:
Date of Birth:
Drivers License Number:
Drivers License State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Drivers License Exp:
Mobile Phone:
Home Phone:
Email:
Time at Residence:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Residence Type:
Rent
Own
Living with Family
Military Housing
Other
Rent/Mortgage:
Applicant Employment Information
Employer:
Employer Type:
Full-Time
Part-Time
Temporary
Fixed Income
Self-Employed
Cash Income
Monthly Income:
Occupation:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Work Phone:
Time on Job:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Do you have a co-buyer?
Add Co-Buyer
Remove Co-Buyer
Co-Buyer Information
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Social Security:
Date of Birth:
Drivers License Number:
Drivers License State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Drivers License Exp:
Mobile Phone:
Home Phone:
Email:
Time at Residence:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Residence Type:
Rent
Own
Living with Family
Military Housing
Other
Rent/Mortgage:
Co-Buyer Employment Information
Employer:
Employer Type:
Full-Time
Part-Time
Temporary
Fixed Income
Self-Employed
Cash Income
Monthly Income:
Occupation:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Work Phone:
Time on Job:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Vehicle Information
Vehicle To Finance:
Select Vehicle to Finance
2021 Harley-Davidson FXBBS STREET BOB Black RWD Select 6 Speed Motorcycle - Cruiser No data Gasoline hd2606 2 Cylinders - hd2606
2020 Harley-Davidson FXST SOFTAIL Black RWD Leatherette 6 Speed Motorcycle - Cruiser Select Gasoline HD3165 2 Cylinders - HD3165
2020 Harley-Davidson FXLRS SOFTAIL LOW Silver RWD Leatherette 6 Speed Motorcycle - Cruiser No data Gasoline HD5726 2 Cylinders - HD5726
2020 Harley-Davidson FXBB FXBB STREET BOB Green RWD Select 6 Speed Motorcycle - Cruiser No data Gasoline HD6563 2 Cylinders - HD6563
2020 Harley-Davidson FLSL SOFTAIL SLIM Gray RWD Leatherette 6 Speed Motorcycle - Cruiser No data Gasoline HD64672 2 Cylinders - HD64672
2016 Harley-Davidson FLSTCI HERITAGE CLASSIC Black RWD Leatherette 6 Speed Motorcycle - Cruiser 1690CC Gasoline HD4559 2 Cylinders - HD4559
2015 Harley-Davidson FLTRXS ROAD GLIDE SPECIAL Black RWD Leatherette 6 Speed Motorcycle - Touring No data Gasoline HD9179 2 Cylinders - HD9179
2014 Harley-Davidson FLSTFB FATBOY LOW Tan RWD Leatherette 5 Speed Motorcycle - Touring 1690CC Gasoline HD7106 2 Cylinders - HD7106
2014 Harley-Davidson FLHXI Street Glide Black RWD Leatherette 6 Speed Motorcycle - Touring 1690CC Gasoline hd2991 2 Cylinders - hd2991
2013 Harley-Davidson FXSBSE BREAKOUT CVO Silver RWD Leather 6 Speed Motorcycle - Cruiser No data Gasoline HD0332 2 Cylinders - HD0332
2013 Harley-Davidson FLHXI STREET GLIDE Black RWD Leatherette 6 Speed Motorcycle - Touring 1690CC Gasoline HD4866 2 Cylinders - HD4866
2013 Chevrolet Silverado 2500HD Work Truck Crew Cab 2WD White RWD Vinyl Automatic Truck 6.0L V8 OHV 16V FFV Gasoline CH6471 8 Cylinders - CH6471
2013 Chevrolet Express 2500 Cargo White RWD Vinyl Automatic Cargo Van Select Gasoline CH2606 8 Cylinders - CH2606
2012 Harley-Davidson FLHXI STREET GLIDE Red RWD Leatherette 6 Speed Motorcycle - Touring 1690CC Gasoline HD4288 2 Cylinders - HD4288
2011 Harley-Davidson VRSCF V ROD MUSCLE Black RWD Leatherette 5 Speed Motorcycle - Cruiser 1250CC HD1571 2 Cylinders - HD1571
2010 Honda VT1300CS SABER Black RWD Vinyl 5 Speed Motorcycle - Cruiser 1312CC Gasoline HN0983 2 Cylinders - HN0983
2010 Harley-Davidson FLTRX ROAD GLIDE CUSTOM Black RWD Leatherette 6 Speed Motorcycle - Touring 1584CC Gasoline HD8474 2 Cylinders - HD8474
2008 Harley-Davidson FXD DYNA SUPER GLIDE Black RWD Leatherette 6 Speed Motorcycle - Cruiser 1584CC Gasoline HD0672 2 Cylinders - HD0672
2008 Harley-Davidson FLSTN SOFTAIL DELUXE White RWD Leatherette 6 Speed Motorcycle - Cruiser 1584CC HD7244 2 Cylinders - HD7244
2008 Harley-Davidson FLHTCU ULTRA CLASSIC Pearl White RWD Leatherette 6 Speed Motorcycle - Touring 1584CC HD1877 2 Cylinders - HD1877
2005 Harley-Davidson FLHRSI ROAD KING CUSTOM Gray RWD Leatherette 5 Speed Motorcycle - Touring 1450CC Gasoline HD4662 2 Cylinders - HD4662
2004 Harley-Davidson FXSTDI SOFTAIL DEUCE Blue RWD Leatherette 5 Speed Motorcycle - Cruiser 1450CC HD8014 2 Cylinders - HD8014
2004 Harley-Davidson FLSTCI HERTIAGE CLASSIC Black RWD Leatherette 5 Speed Motorcycle - Cruiser 1450CC HD0500 2 Cylinders - HD0500
2004 Harley-Davidson FLSTC HERITAGE CLASSIC White RWD Leatherette 5 Speed Motorcycle - Cruiser 1450CC Gasoline HD5075 2 Cylinders - HD5075
2003 Harley-Davidson FXSTD SOFTAIL DEUCE Blue RWD Leatherette 5 Speed Motorcycle - Cruiser 1450CC Gasoline HD2189 2 Cylinders - HD2189
1998 Harley-Davidson FXDWG DYNA WIDE GLIDE Black RWD Leatherette 5 Speed Motorcycle - Cruiser 1340CC Gasoline HD15274 2 Cylinders - HD15274
1997 Harley-Davidson FXDS Conv DYNA SUPER GLIDE Black RWD Leatherette 5 Speed Motorcycle - Cruiser 1340CC Gasoline HD5113 2 Cylinders - HD5113
Stock Number:
Year:
Make:
Model:
Trim:
Vin:
Mileage:
Additional Comments
ACKNOWLEDGMENT AND CONSENT:
I certify that the above information is complete and accurate to the best of my knowledge. Creditors receiving this application will retain the application whether or not it is approved. Creditors may rely on this application in deciding whether to grant the requested credit. False statements may subject me to criminal penalties. I authorize the creditors to obtain credit reports about me on an ongoing basis during this credit transaction and to check my credit and employment history on an ongoing basis during the term of the credit transaction. If this application is approved, I authorize the creditor to give credit information about me to its affiliates.
ACKNOWLEDGMENT AND CONSENT:
I hereby consent to receive text messages or phone calls from or on behalf of the dealer or their employees to the mobile phone number I provided above. By opting in, I understand that message and data rates may apply. This acknowledgement constitutes my written consent to receive text messages to my cell phone and phone calls, including communications sent using an auto-dialer or pre-recorded message. You may withdraw your consent at any time by texting "STOP".
Submit Credit App
Text Us
Text us
×
Close
First Name
Last Name
Mobile Phone
Comments
ACKNOWLEDGMENT AND CONSENT:
I hereby consent to receive text messages or phone calls from or on behalf of the dealer or their employees to the mobile phone number I provided above. By opting in, I understand that message and data rates may apply. This acknowledgement constitutes my written consent to receive text messages to my cell phone and phone calls, including communications sent using an auto-dialer or pre-recorded message. You may withdraw your consent at any time by texting "STOP".