Gold Road Auto: Credit Application Form

If you have any questions, do not hesitate to contact us:

732-487-0312 | 732-209-3687

yk@goldroadauto.com | hg@goldroadauto.com
CREDIT APPLICATION FORM
PERSONAL INFORMATION
Name*

First NameMiddle NameLast Name
DOB*

MonthDayYear
Date of Birth
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
SSN*
Drivers License Number*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Residential Status*
Monthly Payment/Rent*
Years at Current Address*

CO-APPLICANT PERSONAL INFORMATION

If you are filing individually, skip this page. If you are filing for credit with another person, please complete this entire form, as incomplete applications will not be processed.
Name

First NameMiddle NameLast Name
DOB

MonthDayYear
Date of Birth
Email
example@example.com
Phone Number
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
SSN
Drivers License Number
Address

Street Address

Street Address Line 2

CityState

Zip Code
Residential Status
Monthly Payment/Rent
Years at Current Address

CO-APPLICANT EMPLOYMENT INFORMATION

If you are filing individually, skip this page. If you are filing for credit with another person, please complete this entire form, as incomplete applications will not be processed.
Current Employer Company Name

Company Name

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Employers Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employers Email
example@example.com
Your Position
Annual Income
Length of Employment

ADDITIONAL NOTES
Check below*

I authorize Gold Road Auto/ Y&H Leasing LLC and any dealership or bank they work with to use this information provided on this form to obtain credit on my behalf. I take full responsibility on my vehicles to and from the dealership(s). The responsibility extends to when they are in the delivery process with my new vehicle or when I instruct Gold Road Auto / Y&H Leasing LLC to take point on returning any lease return on my behalf to the bank. I understand it is my obligation by law to have my vehicles insured at all times with comprehensive collision.
Check below*

I affirm all of the above information is correct.
Signature*

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Date*

MonthDayYear
Date
Co-Applicant Signature

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Date

MonthDayYear
Date
Should be Empty:

CREDIT APPLICATION FORM