Credit Application

APPLICANT IDENTITY

First Name and Middle Initial

Last Name

Street Address

City

State

ZIP Code

Date of Birth

Phone

Work Phone

Social Security Number

Drivers License Number

Drivers License State

Attention:

Simply fill out the above fields and submit the form to get started, and we will follow up with you.

If you provide additional information below, it will expedite the process.

APPLICANT RESIDENCE

Do you rent or own your residence?

Landlord/Mortgage Holder

Rent/Mortgage Monthly Amount

Time at Current Residence

Years:

Months:

PRIOR RESIDENCE

Did you rent or own your previous residence?

Street Address

City

State

ZIP Code

Time at Prior Residence

Years:

Months:

PRIOR RESIDENCE #2

Did you rent or own your previous residence?

Street Address

City

State

ZIP Code

Time at Prior Residence

Years:

Months:

APPLICANT EMPLOYMENT

Place of Employment

Street Address

City

State

ZIP Code

Occupation

Business Phone

Salary Period

Gross Salary

Net Salary

Other Income

** Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Retired

Retirement Income

Time at Current Employer

Years:

Months:

PRIOR EMPLOYMENT

Place of Employment

Street Address

City

State

ZIP Code

Occupation

Business Phone

Time at Prior Employer

Years:

Months:

PRIOR EMPLOYMENT #2

Place of Employment

Street Address

City

State

ZIP Code

Occupation

Business Phone

Time at Prior Employer

Years:

Months:

APPLICANT BANKING

Name of Bank #1

Account Types #1

Name of Bank #2

Account Types #2

Lender (Mortage / Car Loan)

Monthly Loan Service Payment

Total Debt

Length of Loan

Years:

Months:

Comments

CO-APPLICANT IDENTITY

First Name

Last Name

Phone

Work Phone

Date of Birth

Social Security Number

Drivers License Number

Drivers License State

CO-APPLICANT RESIDENCE

Same as Primary Buyer

Street Address

City

State

ZIP Code

Does the co-applicant rent or own their residence?

Landlord/Mortgage Holder

Rent/Mortgage Monthly Amount

Time at Current Residence

Years:

Months:

PRIOR RESIDENCE

Did the co-applicant rent or own their previous residence?

Street Address

City

State

ZIP Code

Time at Prior Residence

Years:

Months:

PRIOR RESIDENCE #2

Did the co-applicant rent or own their previous residence?

Street Address

City

State

ZIP Code

Time at Prior Residence

Years:

Months:

CO-APPLICANT EMPLOYMENT

Place of Employment

Street Address

City

State

ZIP Code

Occupation

Business Phone

Salary Period

Gross Salary

Net Salary

Other Income

**Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Retired

Retirement Income

Time at Current Employer

Years:

Months:

PRIOR EMPLOYMENT

Place of Employment

Street Address

City

State

ZIP Code

Occupation

Business Phone

Time at Prior Employer

Years:

Months:

PRIOR EMPLOYMENT #2

Place of Employment

Street Address

City

State

ZIP Code

Occupation

Business Phone

Time at Prior Employer

Years:

Months:

PRIVACY INFORMATION

Privacy Statement

Introduction
As a valued customer, we want to ensure your private information is kept private and only shared with those companies who are authorized either by yourself or as allowed or required by law. This document explains our privacy policy, gives you reasons why we ask for the type of information we do, and if we do reserve a right to share information with non-affiliated third parties, lets you "opt-out" of our reservation to do so. Please take a moment to read this entire policy.

Collection of Information
The purchase of a motor vehicle requires considerable accumulation of nonpublic personal information. For example, if we sell or lease you a vehicle - extending you credit at your request - we will receive information from you in order to determine your creditworthiness. We may also obtain information from a credit-reporting agency. We may also obtain information from third parties such as employers, references and insurance companies.

Some of the information we obtain from you may be required by state of federal agencies, such as the Department of Motor Vehicles or the Internal Revenue Service. This information may be required even if you were to pay cash for your vehicle. Examples would be a driver's license or social security number.

Protecting Your Information
We safeguard nonpublic personal information according to established industry standards and procedures. We maintain physical and electronic safeguards that comply with state and federal law. We restrict access to nonpublic personal information about you to those employees and outside contractors who need to know the information to provide product or service to you. We prohibit our employees and agents from giving information about you to anyone in a manner that would violate any applicable law or our privacy policy.

Information Sharing
Unless we have indicated our desire to share your nonpublic personal information with non-affiliated third parties (by checking the box in the section below), we share information:

A) For everyday business purposes, such as to process transactions, maintain account(s), respond to court orders and legal investigations, or report to credit bureaus.

B) For purposes of processing a sale or lease transaction as your request or authorize, such as submitting information to third party financial institutions that may be requested to take an assignment of the contract or verifying insurance coverage information.

C) When using outside service providers to help us provide you with products and services. Before providing information to our service providers we enter into contractual agreements prohibiting them from disclosing or using the information other than for the purpose it was disclosed.

D) With "Affiliated" companies. Companies that are affiliated with us include any company that controls us, any company we control, or any company under common control with us.

I am interested in purchasing or leasing a vehicle and request that my Consumer Credit Report be obtained, at no cost to me, in order to help determine the types and extent of financing which may be available to me.

I Authorize

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