5 Star Auto Plaza's Finance Form
Your Contact Information
Name
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First Name
Last Name
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Residence Or Work Phone
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Date Of Birth
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Month
/
Day
Year
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Social Security Number
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E-Mail Address
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Physical Address
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Do You Rent or Own
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Rent
Own
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Rent/Mortgage
*
Monthly Amount
Years At Residence
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How long at current home in years
Months At Residence
How long at current home in Months
If less than 2 years, please fill out the previous residence.
Previous Residence Address
Street Address
Street Address Line 2
City
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Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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Hawaii
Idaho
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Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
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Mississippi
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Ohio
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Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State (Example: WA)
Zip Code
Time at Previous Residence in Years
Years
Time at Previous Residence in Months
Months
Employer Information
Job Title
*
Employer Name
*
Employer Phone Number
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Time At Employer
(Years)
Income
*
Monthly Income
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Co-Applicant (Skip If Not Applicable)
Co-Applicant Name
First Name
Last Name
Co-App Phone Number
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Co-App Home Phone
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Co-App Address
Street Address
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City
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Postal / Zip Code
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