APPLICATION FOR CREDIT Lara Auto Sales

CREDIT APPLICATION
Please complete all appropriate sections, providing at least two years of residence and employment history. (If additional space is needed, please use back on this application READ TO APPLICANT: "If married, you have the right to apply for credit separately from or jointly with your spouse."
Purpose
Amount Requested
Source
Applicant: Name (Last, First, Middle)
Social Security No.
Date of birth

MonthDayYear
Date
Residence Address: (Street, City, State, Zip)
How Long?
Mailing Address: (if different from residence address)
Home Phone No.

Area CodePhone Number
Cell Phone No.

Area CodePhone Number
Previous Address: (if less than 2 years)
How Long?
No. Dependents
Select One Option

BuyOwnRentOther
Landlord or Mortgage Holder
Mortgage or Rent Payment
Purchase price of Property
Estimated Home
1st Mort. Balance
Employer's Name and Address
Occupation
Employment Date
Work Phone No.

Area CodePhone Number
Monthly Income from Employer - GROSS
Monthly Income from Employer - NET
Previous Employer
Employment Date
All Other Monthly Income
Source(s) of Other Income
Total Monthly Income - GROSS
Total Monthly Income - NET
CO APPLICANT: Name (Last, First, Middle)
Social Security No.
Date of birth

MonthDayYear
Date
Residence Address: (Street, City, State, Zip)
How Long?
Home Phone No.

Area CodePhone Number
Cell Phone No.

Area CodePhone Number
No. Dependents
Select One Option

BuyOwnRentOther
Mortgage or Rent Payment
Employer's Name and Address
Occupation
Employment Date
Cell Phone No.

Area CodePhone Number
Monthly Income from Employer - GROSS
Monthly Income from Employer - NET
Previous Employer
Employment Date
All Other Monthly Income
Source(s) of Other Income
Total Monthly Income - GROSS
Total Monthly Income - NET
OTHER INCOME: (Read to applicant: "Income from alimony, child support or separate maintenance need not be revealed if you do not choose to rely on such income in applying for credit.
Have you taken bankruptcy within the las 7 years?

NOYES
If yes, indicate year taken
Driver's License No. and State (or State ID No.)
Other Qualifying I.D
Applicant's Signature*

Clear
Date

MonthDayYear
Date
Co Applicant's Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

CREDIT APPLICATION