APPLICANT'S CREDIT STATEMENT
PLEASE PRINT CLEARLY TO ENSURE TIMELY PROCESSING.
DEALER FAX BACK NUMBER
-
-
APPLICANT'S CREDIT STATEMENT
Individual Credit
Joint Credit Community Property State Business Application
If you are applying for individual credit in your own name and are relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit requested, complete Section A. If this is an application for joint credit with another person, complete Sections A and B, providing information in B about the joint applicant
We intend to apply for joint credit. Applicant
Co-Applicant
If you are applying for individual credit, but are relying on income from alimony, child support or separate maintenance or on the income or asset of another person as the basis for repayment of the credit requested complete Sections A and B to the extent possible, providing information in B about the person on who alimony, support or maintenance payments or income or assets you are relying on. Section B should also be completed if you reside in a Community Property state and are married and you are relying on the income or assets of your spouse for repayment of the credit requested.
SECTION A. - Information Regarding Applicant
SOCIAL SECURITY NUMBER or (TAX ID #)
FIRST NAME OR BUSINESS NAME
MI
LAST NAME
DATE OF BIRTH MM/DD/YY
/
/
CURRENT STREET NUMBER AND STREET NAME
HOME PHONE
-
PO BOX NUMBER
-
APT/SUITE NUMBER
CITY
STATE
ZIP CODE
TIME AT ADDRESS
Own
Family
YRS
MOS
Rent
Other
EMPLOYED BY or TYPE OF BUSINESS (if business application)
MTG PYMT OR RENT OCCUPATION
HOME FINANCED BY
BUSINESS PHONE
TIME EMPLOYED
ANNUAL SALARY (GROSS)
-
-
YRS
MOS
Alimony, child support, separate maintenance income or its source need not be disclosed unless Applicant wants the Creditor to consider it in connection with application.
OTHER INCOME
SOURCE OF OTHER INCOME
PREVIOUS EMPLOYMENT (if less than 2 yrs at current) BANK NAME
BUSINESS PHONE
-
-
CHECKING/SAVINGS ACCOUNT (BANK ACCOUNT #
TIME EMPLOYED YRS
MOS
CONTACT NAME AT BANK (IF BUSINESS APPLICATION
NEAREST RELATIVE OR FRIEND NOT LIVING WITH YOU NAME
FOR DEALER USE ONLY
DEALER NAME
VEHICLE YR.
MAKE
BUSINESS PHONE
-
-
ADDRESS
New Retail
Used
Single Pay Lease
Lease
Balloon
DEALER NUMBER
MODEL DESCRIPTION
PHONE
USED VEHICLE OPTIONS
A/C
Pwr. Windows
Sunroof
Pwr. Seats
Stereo
Pwr. Door Locks
Cruise MILEAGE
Alum./Wire Wheel
Man. Trans. 4WD T-Top Leather Seats
TERM
CASH SELLING PRICE
(YR.) TRADE IN (MAKE)
NET TRADE (MODEL)
CASH/CAP RED/REBATE INVOICE/USED CAR VALUE
CAP COST OR UNPAID BAL MSRP
EST PAYMENT
SECTION B. - Information Regarding Joint Applicant or other party (use separate sheet if necessary)
SOCIAL SECURITY NUMBER or TAX ID #) FIRST NAME OR BUSINESS NAME
MI
LAST NAME
DATE OF BIRTH MM/DD/YY
/
/
CURRENT STREET NUMBER AND STREET NAME
HOME PHONE
-
PO BOX NUMBER
-
APT/SUITE NUMBER
CITY
STATE
ZIP CODE
TIME AT ADDRESS
Own
Family
YRS
MOS
Rent
Other
EMPLOYED BY or TYPE OF BUSINESS (if business application)
MTG PYMT OR RENT OCCUPATION
HOME FINANCED BY
BUSINESS PHONE
TIME EMPLOYED
ANNUAL SALARY GROSS
-
-
YRS
MOS
Alimony, child support, separate maintenance income or its source need not be disclosed unless Go-Applicant wants the Creditor to consider it in connection with application.
OTHER INCOME
SOURCE OF OTHER INCOME
PREVIOUS EMPLOYMENT (if less than 2 years at current)
BUSINESS PHONE
-
-
This application may be submitted to the following financial institutions [Name(s) and Address(es)]
TIME EMPLOYED YRS
MOS
BY SIGNING BELOW , YOU CERTIFY THAT YOU HAVE READ AND AGREE TO THE TERMS AND DISCLOSURES AND ON THE REVERSE SIDE OF THE APPLICATION
x
x
APPLICANT'S SIGNATURE
DATE
CO-APPLICANT'S SIGNATURE
DATE
*The trade name ''Subaru Motors Finance'' and the Subaru logo are owned by Subaru of America, Inc. and are licensed to
JPMorgan Chase Bank, N.A. (''Chase'') and Chase Auto Finance Corp. (''CAFC''). Chase is the creditor on retail accounts
and CAFC is the creditor on lease accounts.
FORM NO. SMF-CREDIT APP REV. 2/05 Ptg.07/05 To ORDER CALL (800)422-3102 OR FAX 888 299-8534 ? 2005 JPMorgan Chase Bank, N.A.
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