Generic credit application

[Pages:1]Dealer Name:

Tel:

Contact:

Credit Application

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:

Male Female Date of birth:

SSN:

Driver's License:

Home:

Work:

Cell:

E-Mail:

Current address & Type: Own Rent Other Previous address 1: Current Employer:

Landlord/Mortgage Co. & Phone:

Years Months

Previous address 2: Phone:

Title:

Years Months Years Months

Employer Address: Other Income:

Income:

Years

Months

Source (Alimony, child support or separate maintenance income need not be revealed if you do not wish):

Previous Employer 1:

Phone:

Title:

Employer Address: Previous Employer 2:

Income: Phone:

Title:

Years Months

Employer Address:

Complete the following information: Are you obliged to make Alimony, Support or Maintenance payments? No Yes

Income:

Years Months

If yes, to (Name & Address) __________________________________________________________________ Amt. per month $______________

Are you a co-maker, endorser, or guarantor on any loan or contract? No Yes If yes, for whom? _______________ To whom? ___________

Are there any unsatisfied judgments against you? No Yes If yes, to whom owed? _______________________ Amount $______________

Have you been declared bankrupt in the last 10 years? No Yes If yes, where? ____________________________ Year?________________

SIGNATURES ? 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:

l. Total Price: (Sum a:g)

h. Total Cash Down:

i. Trade Value:

j. Trade Payoff:

k. Net Trade Value: m. Total Down: (Sum h:k)

Amount Financed (l-m)

Form printed using ? online dealer management solutions | Visit or call 888.90.FUNDS (38637) to learn more

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