Dealer_Information_Sheet_VAC_ALC_20120827.xlsx



Please call Chip Parker at 972-743-8406This form is property of ALC ? 2012. All Rights Reserved.The Auto Loan CompanyDealer Information SheetPlease fax to 972-242-9909WebsiteDealer Facebook PageDealer's Legal Name Licensed StatePrimary Phone:--Primary Fax:Twitter--Dealer E-mail AddressYES NOOK for Funding NotificationsOK For General NotificationsBusiness AddressStreetCity, StatePrior Business Address if at current location less than 3 yearsZIPStreetCity, StateZIPZIPDealership's Landlord ReferenceNameStreet//Funding Bank Account Information Banking InstitutionDATE OPENED//Local Bank Branch City, State,Phone #--Must be a checking account authorized Routing / Transit Numberfor DEBITS and CREDITS.Account Number9 digits to be a valid routing / transit numberCity, StateLandlord's PhoneDealer Owns PropertyDealer Leases Property--Lease Expires //Dealership Business Formation:S-CorpC-Corp PartnershipOperate in multiple statesDate Company Formed:(Circle all that apply- explain in notes)Sole ProprietorshipDBARelated Finance CompanyState Company Formed In:-////Tax Identification Number: Dealer License Number: Dealer License Expiration: Date Dealership Opened:Clearly explain the relationships below in Notes (on back of this form): Floorplan Relationships:Line Of Credit Facilities: Bulk Buying Relationships:Related lots and businesses:The following questions are applicable to all of the principals, entities or interested parties related to this dealership. If YES, please provide detailed explanation.Filed for bankruptcy protection?YESNODefaulted on a financial obligation?YESNOConvicted of a felony?YESNOParty to a lawsuit?YESNOConvicted of any crime related to financial institutions?YESNOOutstanding tax liens, judgments or non-current debt?YESNOALL principals, officers and interested parties (Include Full name and SS# here). List additional principals, officers and banking and/or financing references on back.Primary Principal (Fill out Personal Information Form)InitialPrincipal or Officer (Fill out Personal Information Form)InitialPrincipal or Officer (Fill out Personal Information Form)InitialThe officers, owners and principals authorize The Auto Loan Company to conduct individual and company credit, financial and licensing investigations, and authorize queried parties to release applicable information as permitted by law. The individual signing this agreement is duly authorized to do so. False, fraudulent or misleading statements may lead to prosecution by the Attorney General (ref. 18 U.S.C. §1001). All information provided herein is accurate and fully complete.InitialManaging Member, Partner or Authorized Agent forDealership (Print Name):SignatureTitleDateDealer represents and warrants to The Auto Loan Company that Dealer presently maintains, and will continue to maintain appropriate information security programs and measures designed to ensure the privacy, security and confidentiality of “Consumer Information” (as defined in 16 C.F.R. §314). Compliance with applicable security policies will be maintained at all times.? 2012 The Auto Loan Company ‐ 8/27/2012 4:28 PM ‐ Dealer_Information_Sheet_ALC_20120827.xlPlease call Chip Parker at 972-743-8406This form is property of ALC. ? 2012. All Rights Reserved.The Auto Loan CompanyPage 2 of 2 - Additional notes for explanation of entries on the front side of this form. Please fax to 972-242-9909 Additional Notes ? 2012 The Auto Loa n Company - 8/27/2012 4:28 PM - Dea ler_l nformation_Sheet__A LC_20120827.xlsxPlease call Chip Parker at 972-743-8406This form is property of ALC. ? 2012. All Rights Reserved.Dealership: First Name:Last Name:The Auto Loan Company Personal Information Form - One Form Per Person Please fax to 972-242-9909--//Social Security Number: Date of Birth:------Title at or relationship with Dealership: Phone Number:Cell Phone Number:Fax Number:Primary E-Mail Address:Copy this address on deal funding e-mails? Dealership Correspondence? Receive ALC notifications?YESNOYESNOYESNOYESNO Occasional marketing from ALC ?Street: City:Home AddressName: Your position:State:Zip:-EmployerStreet:Business AddressState:Zip:-City:--Work Phone Number: Work E-Mail Address:Additional Information: Print NameSignatureI authorize ALC to conduct individual credit and financial investigations, and authorize queried parties to release applicable information as permitted by law. The individual signing this agreement is duly authorized to do so. False, fraudulent or misleading statements may lead to prosecution by the Attorney General (ref. 18 U.S.C. §1001). All information provided herein is accurate and fully complete.InitialDate? 2012 The Auto Loan Company ‐ 8/27/2012 4:28 PM ‐ Dealer_Information_Sheet__ALC_20120827.xlsx ................
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