Blue Bolt Personal Credit Application

Blue Genie Auto Group

Personal Application Form
What type of lending are you applying for?*

LeaseFinanceFull-Pay
Who is applying for lending?*

Individual ApplicationCo-Application
Applicant Information
Full Name (As it appears on your Drivers License)*

PrefixFirst NameMiddle NameLast Name
Gender*

MaleFemaleN/A
Marital Status*

SingleMarriedOther
Date of Birth*

MonthDayYear
Social Security Number/Tax ID*
Drivers License Number*
Drivers License State of Issuance*
Phone Number*
E-Mail*
example@example.com
Address*

Street Address

Apt/Unit

CityState

Zip Code
Housing Status*

RentMortgageOwn Home OutrightLiving With Family Members
Monthly Housing Payment*
How long have you lived at your given address?*

0-1 Year1-2 Years3-4 Years5+ Years
Previous Address (If less than 2-Years)

Street Address

Apt/Unit

CityState

Zip Code
Applicant Employment Information
Employment Status*

Full-TimePart-TimeSelf-EmployedRetired
Gross Annual Income*
Employer/Business Name*
Title/Position*
Work Phone Number*
Employment Address*

Street Address

Apt/Unit

CityState

Zip Code
How long have you worked at your current employment ?*

0-1 Year1-2 Years3-4 Years5+ Years
Previous Employer/Business Name (If less than 2-Years)
Previous Title/Position
Previous Work Phone Number
Previous Employment Address

Street Address

Apt/Unit

CityState

Zip Code
Co-Applicant Information
Relationship to Applicant
Gender

MaleFemaleN/A
Marital Status

SingleMarriedOther
Full Name (As it appears on your Drivers License)

PrefixFirst NameMiddle NameLast Name
Date of Birth

MonthDayYear
Social Security Number/Tax ID
Drivers License Number
Drivers License State of Issuance
Phone Number
E-Mail
example@example.com
Address

Street Address

Apt/Unit

CityState

Zip Code
Housing Status

RentMortgageOwn Home OutrightLiving With Family Members
Monthly Housing Payment
How long have you lived at your given address?

0-1 Year1-2 Years3-4 Years5+ Years
Previous Address (If less than 2-Years)

Street Address

Apt/Unit

CityState

Zip Code
Co-Applicant Employment Information
Employment Status

Full-TimePart-TimeSelf-EmployedRetired
Gross Annual Income
Employer/Business Name
Title/Position
Work Phone Number
Employment Address

Street Address

Apt/Unit

CityState

Zip Code
How long have you worked at your current employment ?

0-1 Year1-2 Years3-4 Years5+ Years
Previous Employer/Business Name (If less than 2-Years)
Previous Title/Position
Previous Work Phone Number
Previous Employment Address

Street Address

Apt/Unit

CityState

Zip Code
General Disclosures & Agreements
I authorize prospective Credit Grantors/Lending/Leasing Companies to obtain personal and credit information about me from my employer and credit bureau, or credit reporting agency, any person who has or may have any financial dealing with me, or from any references I have provided. This information, as well as that provided by me in the application, will be referred to in connection with this lease and any other relationships we may establish from time to time. Any personal and credit information obtained may be disclosed from time to time to other lenders, credit bureaus or other credit reporting agencies. * Please select the appropriate box(s) below.*

Applicant AuthorizationCo-Applicant Authorization
I hereby agree that the information given is true, accurate and complete as of the date of this application submission. * Please select the appropriate box(s) below.*

Applicant ApprovalCo-Applicant Approval
Applicant Signature*

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Co-Applicant Signature

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Please upload all supporting documents below

EX: Drivers License(s), Vehicle Registration, Insurance Cards, Bank Documents
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Blue Genie Auto Group

Applicant Information

Applicant Employment Information

Co-Applicant Information

Co-Applicant Employment Information

General Disclosures & Agreements