Car Loan Application Form
Personal Details
Name
*
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Status
Single
Married
Seperated
Divorced
Widowed
Email
*
example@example.com
Phone Number
*
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
National Identity Number
*
Driver's License Number
Are you currently working?
*
Yes
No
Company
Position
Department
Emergency Contact Info
First Name
Last Name
Phone #
Financial Details
Current Bank Name
Branch
Account Type
Current
Saving
Deposit
Other
Account Number
Do you own or rent your home?
Own
Rent
Do you have any current loan?
Yes
No
Monthly Net Income
in USD
Loans
Vehicle Details
Make & Model
Variant
Registered Month
Registered Year
Recorded Mileage
Engine Size
Insurance has been arranged with
Registration Number
Is the vehicle new or secondhand? (should not be more than 4 years old)
New
Secondhand
HPI / Car Data Check enclosed? (required for all secondhand vehicles)
Yes
No
Independent Engineer's report enclosed?
*
Yes
No
Full Price of Vehicle
in USD
Requested Loan Details
Loan Type
Used Car
New Car
Loan Amount
in USD
Terms
1 year
2 years
3 years
Preferred Payment
monthly
yearly
Other
Do you have a co-signer?
Yes
No
Co-signer name
First Name
Last Name
Co-signer's Phone Number
Co-signer's Social Security Number
Permission to Obtain Consumer Credit Report
By signing this application form, I hereby give the right to obtain a consumer credit report regarding me for this application and the car loan should my application be approved. I also release from all liability all persons, companies, and corporations supplying such information. I the indemnify "XYZ Bank" the against any liability that might result from making such an investigation. I certify that the information above is correct to the best of my knowledge. I authorize "XYZ Bank" to make inquiries as necessary to verify the accuracy of the statements made by me and to determine my creditworthiness. I agree to pay the required sums and I agree to be bound by the loan agreement if my application is accepted.
Signature
Co-signer's Signature
Submit
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