Credit Application

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Section A-Information About Applicant (Information in red is required)

First Name
Middle Name
Last Name Jr/Sr  
Date of Birth mm/dd/yyyy) 
Social Security Number
Home Phone
Home Address
City State  
Zip Code    
Own or Rent? Mortgage or Rent Amount 
How Long There? yrs. mos.
Annual Income
Occupation
Employer
How Long? years   months
Work phone
Email Address
Nearest Living Relative
Relative Address
Relative City, State, Zip

Section B-Information About Co-Applicant (Info in red is required if there is a Co-Applicant)

First Name
Middle Name
Last Name     Jr/Sr
Date of Birth   (mm/dd/yyyy)
Social Security Number
Home Phone
Employer
How Long? years   months
Work Phone
Annual Income
Occupation
Check here if the following information is the same as the Applicant's.
Otherwise, fill in the following information.
Home Address
City State 
Zip Code
How Long? years   months
Email Address
Nearest Living Relative
Relative Address
Relative City, State, Zip

Section C-Asset Information

Deposit Amount

Trade Vehicle (if any) (year/make/model)
 

Section D-Vehicle Information

I am applying for credit on the following vehicle:
New      or    Used  Type (Choose one)   
Make  Model     
Preferred Color
Our Stock Number
Are you currently working with one of our Salespeople? If yes, what is his/her name?
       
 Options/Comments
   

Section E-Customer Notices

By submitting this Credit Application I: 
(1) make the above representations, which I certify  correct for the purposes of obtaining credit 
(2)authorize you or your agent(s) to investigate my credit record, and to gather such other information that you consider necessary,
(3) understand that my application for credit will not be processed unless this form is electronically signed below by checking "I Agree",
(4) understand that you will retain this application whether or not it is approved,
(5) understand that this application is an abbreviated version of a standard credit application. If a loan is available to me based on the information I supply here, I may be required to complete a standard credit application at a later date, and
(6) understand that I will only be contacted if I am eligible for credit approval.

I Agree