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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