Credit Application Form

Retail Motor Vehicle Credit Application

Fill out and submit online today!
TYPE OF CREDIT REQUESTED:

BusinessindividualJoint - We intend to apply for joint credit. The words "you" and "your" refer to each person or business submitting this application. The words "we", "us" and "our" refer to the seller and the financial companies to which your application is submitted. The words "married" and "spouse" include registered domestic partners or civil union where applicable.
IMPORTANT APPLICANT INFORMATION: Federal law requires financial companies to obtain sufficient information to verify your identity. You may be asked several questions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information.
APPLICANT'S INFORMATION
Name

First NameLast Name
Date of Birth

MonthDayYear
SSN/TaxID
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long at address?
Phone Number
Please enter a valid phone number.
Monthly Rent/Mortgage
Applicants Email Address
example@example.com
Residential Status

OwnRentWith RelativesWith FriendsOther
Landlord/Mortgage
Landlord Phone Number
Please enter a valid phone number.
Previous Address (if less that 2 years at current address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long?
Current Employer
Gross Monthly Salary
Current Employer's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long?
Occupation/Job Title
Previous Employer (if less than 2 years at current job)
Phone Number
Please enter a valid phone number.
Gross Monthly Salary
Previous Employer's Full Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long?
Secondary Employer Name (if applicable)
Secondary Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gross Monthly Salary
Secondary Employer Phone
Please enter a valid phone number.
How long?
Occupation/Job Title
JOINT APPLICANT'S INFORMATION

Complete JOINT APPLICANT'S section only if application is for joint credit.
Name

First NameLast Name
Date of Birth

MonthDayYear
SSN/TaxID
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long at address?
Phone Number
Please enter a valid phone number.
Monthly Rent/Mortgage
Applicants Email Address
example@example.com
Residential Status

OwnRentWith RelativesWith FriendsOther
Landlord/Mortgage
Landlord Phone Number
Please enter a valid phone number.
Previous Address (if less that 2 years at current address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long?
Gross Monthly Salary
Current Employer's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
how long?
Occupation/Job Title
Previous Employer (if less than 2 years at current job)
Phone Number
Please enter a valid phone number.
Gross Monthly Salary
Previous Employer's Full Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long?
Secondary Employer Name (if applicable)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gross Monthly Salary
Secondary Employer Phone
Please enter a valid phone number.
How long?
Occupation/Job Title
* Alimony, child support, or separate maintenance incomes do not have to be revealed unless the applicant wishes to have such sources considered as a basis for repayment of the requested credit amount.
Signatures
You certify that the information given above is true and complete. We will rely, in part, on this information to evaluate your eligibility for credit. You authorize us to submit this application and any other documents pertaining to this proposed transaction to the following financial company(ies):

You authorize these financial companies and their affiliates to obtain any information they want in order to verify information related to this credit application, including contacting a spouse to verify spouse related information.
Applicant's Signature

Clear
Date

MonthDayYear
DL #
Jt. Applicant's or Other Party's Signature (when applicable)

Clear
Date

MonthDayYear
DL #
Notices
Notice to applicants or other parties subject to the laws of CALIFORNIA: APPLICANT, IF MARRIED, MAY APPLY FOR A SEPARATE ACCOUNT. Notice to applicants or other parties subject to the laws of NEW HAMPSHIRE: IF THIS IS AN APPLICATION FOR A BALLOON RETAIL SALES CONTRACT, APPLICANTS ARE ENTITLED, UPON REQUEST, TO RECEIVE A WRITTEN ESTIMATE OF THE MONTHLY PAYMENT FOR A BALLOON PAYMENT REFINANCING IN ACCORDANCE WITH THE CREDITOR'S CURRENT REFINANCING PROGRAMS PRIOR TO ENTERING INTO A BALLOON CONTRACT.

Notice to applicants or other parties subject to the laws of OHIO: OHIO LAWS AGAINST DISCRIMINATION REQUIRE THAT ALL CREDITORS MAKE CREDIT EQUALLY AVAILABLE TO ALL CREDIT-WORTHY CUSTOMERS, AND THAT CREDIT REPORTING AGENCIES MAINTAIN SEPARATE CREDIT HISTORIES ON EACH INDIVIDUAL UPON REQUEST. THE OHIO CIVIL RIGHTS COMMISSION ADMINISTERS COMPLIANCE WITH THIS LAW.

Notice to applicants or other parties subject to the laws of WISCONSIN: MARITAL PROPERTY AGREEMENT NOTICE: No provision of any marital property agreement, unilateral statement under Wisconsin Statutes Section 766.59 or court decree under Wisconsin Statutes Section 766.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the creditor is incurred.
The following is for Wisconsin residents only:
Applicant is

MarriedUnmarried (includes single, divorced or widowed)Separated
If married or separated, and Applicant's spouse is not a joint applicant.

Waiver of Notice by Non-Joint Applicant Spouse: I agree to waive notice of any extension of credit in connection with this application.
Signature of Non-Joint Applicant Spouse

Clear
Date

MonthDayYear
ALL APPLICANTS: IMPORTANT APPLICANT INFORMATION
You authorize us to obtain consumer credit reports from time to time as we want, for any legitimate purpose, in connection with the transaction that is proposed by this application or any future update, renewal, or extension of that transaction. Upon request, you will be informed whether or not a consumer report was ordered. If a report was requested, you will be informed of the name and address of the consumer credit reporting agency that furnished the report. We may keep this application whether or not it is approved. You authorize us to check your credit and employment history and to answer questions others may ask us about your credit record with us.

You agree that your telephone communications with us and any financial company that reviews this credit application may be monitored and/or recorded to assure the quality of service. You give your consent to receive calls and text messages from the creditor or its third party debt collector at any number you have given us, including calls and messages made using an autodialer or prerecorded message. You agree that we can send disclosures or other communications to you electronically at the e-mail address you have given us.

By signing below you acknowledge you have read the applicable notices on this page and agree to the terms of the ALL APPLICANTS: IMPORTANT APPLICANT INFORMATION section.
Applicant's Signature

Clear
Date

MonthDayYear
Jt. Applicant's Signature (when applicable)

Clear
Date

MonthDayYear
Should be Empty:

Retail Motor Vehicle Credit Application

APPLICANT'S INFORMATION

JOINT APPLICANT'S INFORMATION

Signatures

Notices