Generic credit application
Dealer Name:
Tel:
Credit Application
Contact:
IMPORTANT APPLICANT INFORMATION: Federal Law requires financial institutions to obtain sufficient information to verify your identity. You may
be asked several questions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside
sources to confirm the information. The information you provide is protected by our privacy policy and federal law.
Applicant:
Date of birth:
SSN:
Driver¡¯s License:
Home:
Work:
Current address & Type:
Own
Cell:
Rent
E©\Mail:
Other
Landlord/Mortgage Co. & Phone:
Previous address 1:
Years
Months
Previous address 2:
Current Employer:
Phone:
Employer Address:
Income:
Other Income:
Years
Months
Years
Months
Title:
Years
Months
Source (Alimony, child support or separate maintenance income need not be revealed if you do not wish):
Previous Employer 1:
Phone:
Employer Address:
Income:
Previous Employer 2:
Phone:
Employer Address:
Income:
Complete the following information:
Are you obliged to make Alimony, Support or Maintenance payments?
No
Are there any unsatisfied judgments against you?
No
Have you been declared bankrupt in the last 10 years?
No
Years
Months
Title:
Years
Months
Yes
If yes, to (Name & Address) __________________________________________________________________
Are you a co©\maker, endorser, or guarantor on any loan or contract?
Title:
Amt. per month $______________
Yes If yes, for whom? _______________ To whom? ___________
Yes If yes, to whom owed? _______________________ Amount $______________
No
Yes If yes, where? ____________________________ Year?________________
SIGNATURES ¨C I certify that everything I have stated in this application and on any attachments is correct. Lender may keep this application
whether or not it is approved. By signing below I authorize Lender to check my credit and employment history and to answer questions others may
ask lender about my credit record with Lender. I understand that I must update credit information at Lender¡¯s request if my financial condition
changes.
________________________________________________________
Applicant¡¯s Signature
Vehicle Information
Year:
Make & Model:
Trim:
______________________
Date
Mileage:
VIN:
Terms
a. Selling Price:
b. Warranty:
c. GAP:
d. Other:
e. Taxes:
f. Doc Fees:
g. Title/Lien/Reg Fees:
h. Total Cash Down:
i. Trade Value:
j. Trade Payoff:
k. Net Trade Value:
l. Total Price: (Sum a:g)
m. Total Down: (Sum h:k)
Amount Financed (l©\m)
Form printed using ¨C online dealer management solutions | Visit or call 888.90.FUNDS (38637) to learn more
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