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
Financing in Ormond Beach, FL
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
2022 Harley-Davidson XL1200X SPORTSTER 48 Black No data Vinyl 5 Speed Manual Motorcycle - Cruiser 1200CC HD400481 2 Cylinders - HD400481
2021 Harley-Davidson FXLRS LOW RIDER S Black No data 6 Speed Manual Motorcycle - Cruiser 1870CC Gasoline HD63277 2 Cylinders - HD63277
2021 Harley-Davidson FLHX STREET GLIDE Burgundy No data 6 Speed Manual Motorcycle - Touring 1746CC HD610654 2 Cylinders - HD610654
2019 Harley-Davidson FLTRXS ROAD GLIDE SPECIAL Black No data 6 Speed Manual Motorcycle - Touring 1868CC HD601287 2 Cylinders - HD601287
2017 Triumph Bonneville Speedmaster SPEEDMASTER Black No data 6 Speed Manual Motorcycle - Cruiser No data TR866798 2 Cylinders - TR866798
2017 Harley-Davidson XL1200T SPORTSTER 1200T Silver RWD Leatherette 5 Speed Motorcycle - Cruiser 1200 Gasoline HD9964 2 Cylinders - HD9964
2017 Harley-Davidson FLSS SOFTAIL SLIM S Black No data Vinyl 6 Speed Manual Motorcycle - Cruiser 1800CC HD046407 2 Cylinders - HD046407
2017 Harley-Davidson FLHTCU ULTRA CLASSIC Maroon No data 6 Speed Manual Motorcycle - Touring 1750CC Gasoline HD673424 2 Cylinders - HD673424
2016 Victory Cross Country Touring CROSS COUNTY TOURER Pearl White No data 6 Speed Manual Motorcycle - Touring No data VI048049 2 Cylinders - VI048049
2016 Harley-Davidson FLSTC103 HERITAGE CLASSIC Teal No data 6 Speed Manual Motorcycle - Cruiser 1690CC HD022471 2 Cylinders - HD022471
2015 Harley-Davidson FLTRXS ROAD GLIDE SPECIAL Blue No data 6 Speed Manual Motorcycle - Touring 1690CC HD647373 2 Cylinders - HD647373
2015 Harley-Davidson FLHTKL ULTRA LIMITED LOW Red No data Vinyl 6 Speed Manual Motorcycle - Touring 1690CC Gasoline HD703982 2 Cylinders - HD703982
2015 Harley-Davidson FLHTCUTG TRI GLIDE Black No data Motorcycle - Touring 1690CC HD859551 2 Cylinders - HD859551
2015 Harley-Davidson FLD103 DYNA SWITCHBACK Black No data Vinyl 6 Speed Manual Motorcycle - Cruiser 1690CC Gasoline HD327529 2 Cylinders - HD327529
2014 Harley-Davidson FLHTK ULTRA LIMITED Black No data Vinyl 6 Speed Manual Motorcycle - Touring 1690CC Gasoline HD627798 2 Cylinders - HD627798
2014 Harley-Davidson FLHTCUTG TRI GLIDE Black No data 6 Speed Manual Motorcycle - Touring 1690CC HD858257 2 Cylinders - HD858257
2014 Harley-Davidson FLHR103 ROAD KING Red No data 6 Speed Manual Motorcycle - Touring 1690CC HD684709 2 Cylinders - HD684709
2013 Chevrolet Express 2500 Cargo White Select Vinyl Automatic Cargo Van Select Gasoline CH2535 8 Cylinders - CH2535
2012 Harley-Davidson VRSCDX NIGHTROD SPECIAL Black No data Vinyl Motorcycle - Cruiser 1250CC Gasoline HD01456 0 Cylinders - HD01456
2012 Harley-Davidson VRSCDX NIGHT ROD SPECIAL Silver No data 5 Speed Motorcycle - Cruiser 1250CC HD5203 2 Cylinders - HD5203
2012 Harley-Davidson FXS103 Softail Blackline Black No data Vinyl 6 Speed Manual Motorcycle - Cruiser 1690CC Gasoline HD11007 2 Cylinders - HD11007
2012 Harley-Davidson FLTRX103 ROAD GLIDE CUSTOM Black No data 6 Speed Manual Motorcycle - Touring 1690CC HD630893 2 Cylinders - HD630893
2011 Harley-Davidson FLHTCU ULTRA CLASSIC Black No data Leatherette Motorcycle - Touring 1584CC Gasoline HD626282 0 Cylinders - HD626282
2010 Harley-Davidson FLHXXX STREET GLIDE TRIKE Black No data Vinyl Motorcycle - Touring 1690CC Gasoline HD852993 0 Cylinders - HD852993
2009 Suzuki VL800 BOULVARD 800 BLACK No data Vinyl 5 Speed Manual Motorcycle - Cruiser 805CC Gasoline SZ6882 0 Cylinders - SZ6882
2009 Harley-Davidson FLHRC ROAD KING CLASSIC Black No data 6 Speed Manual Motorcycle - Touring 1584CC HD629209 2 Cylinders - HD629209
2006 Harley-Davidson FLHRI ROAD KING Blue RWD Leatherette 5 Speed Motorcycle - Touring 1450CC Gasoline HD8053 2 Cylinders - HD8053
2003 Harley-Davidson FXSTD SOFTAIL DEUCE Blue RWD Leatherette 5 Speed Motorcycle - Cruiser 1450CC Gasoline HD2189 2 Cylinders - HD2189
1995 Harley-Davidson FXDWG DYNA WIDE GLIDE Black No data 5 Speed Manual Motorcycle - Cruiser 1340CC HD308959 2 Cylinders - HD308959
Stock Number:
Year:
Make:
Model:
Trim:
Vin:
Mileage:
Sales Price:
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".