How Long have you been on this Job? (years/months) :
Position held:
Telephone (including area code) :
Employer's address
Address:
City:
State:
Zip:
Can We Contact You at Work?
Yes
No
Gross Weekly Income (before taxes) :
Commission:
If less than 3 years
How Long at Previous Employer (years/months):
Same Line of Work?
Yes
No
Additional sources of income
Specify Source 1:
Amount $:
Specify Source 2:
Amount $:
Credit History
Describe the nature of your credit problem? (if applicable)
Current Budget
How much of a down payment do you have for buying or leasing a vehicle?
What is your budget for a monthly car payment?
Do you have a vehicle you are trading in?
Yes
No
If so Please Describe
Your Trade in
Trade in Year:
Trade in Make:
(Ford, Nissan, KIA, GM, Dodge, etc.)
Trade in Model:
(Taurus, Focus, F-150, Neon, Sentra etc.)
Trade in Kilometers:
Trade in Comments: (if applicable)
Disclaimer
PLEASE READ
By submitting this form, you certify that all of the statements
in this application are true and complete and are made for the purpose
of obtaining credit. You authorize any dealer or lender who receives
this application to retain it, to rely on it and to obtain such
other information as it may require, including credit reports. You
also confirm that you have read the Privacy
Policy and the User Agreement
Sections.
This hereby authorizes the dealers to obtain a credit bureau on
all information provided above. All false declarations will result
in the automatic refusal of the credit application.
