| APPLICANT |
| Name (First,
Middle, Last) |
|
| Date of Birth |
|
| Social Security
Number |
|
| No. Dependents
(Excluding Yourself) |
|
| Address |
|
| Time
at Address
Yrs.
Mos. |
| Home Phone |
|
| Previous Address |
|
| Time
at Address
Yrs.
Mos. |
|
Own
Rent
Live with parents |
|
Other - Explain: |
|
| Mortgage/Rent
Payment |
|
| Approx. Value
of Home |
|
| Name of Mortgage
Holder/Landlord |
|
| Mortgage Balance |
|
| Name & Address
of Current Employer |
|
| Position |
|
| Time
with Employer
Yrs.
Mos. |
| Business Phone |
|
| Monthly
Gross Income* |
|
| Other Monthly
Income* |
|
| Previous Employer
(If Less Than 3 Years) |
|
| Years There |
|
| Position |
|
| Self
Employed/Principal of Corp.
Yrs.
Mos. |
| *
You do not have to reveal alimony, child support, or
separate maintenance income unless you wish to have
them considered for approving your application. |
| Have
You Ever Filed Bankruptcy?
Yes: When:
No |
| Check
the Creditors You Have Accounts With: |
|
MasterCard/Visa/Discover
American/Express/Diners |
|
Finance Company (Please List) |
|
|
Department Store (Please List) |
|
Value of All
Assets Except Home $
|
|
Total Monthly
Payments On All Debts
|
|
Except Mortgage
or Rent $
|
|
Total Balance
of All Debts Owed
|
|
Except Mortgage
$
|
|
Please
fill out the section below for the Nearest Relative
Not Living with You
|
Name
|
|
Address
|
|
Phone
|
|
| Relationship |
|
| |
| CO-APPLICANT |
| Name (First,
Middle, Last) |
|
| Date of Birth |
|
| Social Security
Number |
|
| Home Phone |
|
| Address |
|
| Time
at Address
Yrs.
Mos. |
| Self
Employed / Principal of Corp.
Yrs.
Mos. |
| Name & Address
of Current Employer |
|
| Business Phone |
|
| Time
with Employer
Yrs.
Mos. |
| Monthy Gross
Income* |
|
| Position |
|
| *
You do not have to reveal alimony, child support, or
separate maintenance income unless you wish to have
them considered for approving your application.
|
| Have
You Ever Filed Bankruptcy?
Yes: When:
No |
| |
| DESCRIPTION
OF GOODS BEING PURCHASED: |
| New or Used |
|
| Year |
|
| Manufacturer |
|
| Model |
|
| Type |
|
| Length |
|
| Invoice |
|
| |
| FINANCE
TERMS REQUESTED: |
Cash Price
|
|
| Sales Tax |
|
| Cash Down Payment |
|
| Amount Financed |
|
| Term |
|
| Payment Amt |
|
| |
| TRADE-IN
INFORMATION: |
| Year |
|
| Manufacturer |
|
| Model |
|
| Type |
|
| Length |
|
| Amount Owed |
|
I hereby affirm that the foregoing information is true
and correct and made for the purpose of obtaining
credit. I authorize you to obtain addition information
from any source(s) and each source is hereby authorized
to provide you with such information. I also grant
you permission to obtain a credit report on me for
all legitimate purposes in connection with this transaction.
Such purposes include assisting in making a credit
decision, reviewing my account, and assisting in
taking collection activity. This application, in
any event, shall be and remain the property of the
Lender, and is subject to the completion and acceptance
of the addition credit application documents prior
to any approved
extension of credit.
|
| |
|
 |
|
