Southside Motors: Online Application
SOUTHSIDE MOTORS
4600 E. Carson St. Pittsburgh, PA 15210
412-481-CARS (2277)
CUSTOMERS: _______________________________________________________________________
ADDRESS: ________________________________ HOME PHONE: ______________________
CITY/STATE/ZIP: __________________________ CELL PHONE: _______________________
EMAIL ADDRESS: ___________________________________________________________________
VEHICLE OF INTEREST
Car: _____ SUV: ______ Minivan: ______
Money to Put Down: $___________________ Desired Monthly Payments: $_____________________
GENERAL INFORMATION
Primary Applicant
NAME: __________________________________ Date of Birth: _________________________
Employer: ___________________________ _____ Bankruptcy?: _________________________
Time at Job: _______________________________ Repossessions?: _______________________
Employer Phone: ___________________________ Rent or Own Home: ____________________
Occupation: _______________________________ Monthly Rent/Mortgage: ________________
Gross Monthly Wages: ______________________ Time at Residence: _____________________
Other Income: _____________________________
a. Do you have any open auto loans now? __________________________
Have you ever had a repossession? (Yes will not exclude you from program) _____________
Have you ever filed for bankruptcy (Yes will not exclude you from program) _____________
Co-Applicant (if available)
NAME: __________________________________ Date of Birth: _________________________
Employer: ___________________________ _____ Bankruptcy?: _________________________
Time at Job: _______________________________ Repossessions?: _______________________
Employer Phone: ___________________________ Rent or Own Home: ____________________
Occupation: _______________________________ Monthly Rent/Mortgage: ________________
Gross Monthly Wages: ______________________ Time at Residence: _____________________
Other Income: _____________________________
a. Do you have any open auto loans now? __________________________
b. Have you ever had a repossession? (Yes will not exclude you from program) _____________
c. Have you ever filed for bankruptcy (Yes will not exclude you from program) _____________
TRADE – IN (if applicable)
YEAR: ________ MAKE: ________________ MODEL: _______________ MILEAGE: ____________
By submitting this application, you give Southside Motors permission to review your information to determine eligibility for any and all programs.
Please e-mail or fax this back to us.
Email: customerservice@
Fax: 412-481-0642
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