Apply OnlineC.H. Brown Company Credit Application Online Quick Credit ApplicationAsterisk (*) indicates required field We follow strict industry standards to safeguard the confidentiality of your personal information and secure the transmission of your information from your computer. NOTICE OF JOINT INTENT Check One: We intend to apply for joint credit.I am applying for credit in my own name only, and am relying on my income/assets in my name only for repayment of this loan. APPLICANT(S) INFORMATION Applicant First Name Applicant Last Name Co-Applicant Name Co-Applicant Last Name Phone Number Email Business Title Date of Birth Primary's SSN Joint's SSN Real Estate Owner? YesNo Amount Requesting Home Street Address City/State/Zip Additional Info (seller, equipment, year, cost, etc...) TERMS AND CONDITIONSBox must be checked in order to submit application The undersigned acknowledge(s) that this signed application, submitted for the purpose of obtaining credit from CH Brown Co., is true and correct in every detail and fairly shows my/our financial condition at the time indicated. I/We will give prompt written notice of any subsequent substantial change in such financial condition occurring before discharge of this obligation to you. I/We understand that you will retain this application whether or not you approve the credit in connection with which is submitted. You are authorized to check any credit or employment history or any other information herein. Any willful misrepresentation on this statement could result in a fine and/or imprisonment under provisions of the U.S. criminal code. C.H. BROWN CO20 W Frontage Road Wheatland, WY 82201 Tel: 307-322-2545 Fax: 307-322-9192QUICK LINKSHome Trucks TrailersQUICK LINKSMachinery Ag Equipment Credit AppQUICK LINKS Careers Contact
