Credit Application

AUTO MANIACS LTD

CREDIT APPLICATION

We "GAURANTEE" you will drive. Some restrictions may apply but not limited to credit, identity verification, income, down payment, etc. Please make sure all information is accurate, and true. It will be verified.

Full Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

Area Code Phone Number

Drivers License #

E-mail *

Date of Birth *

Month Day Year

Last 4 digits Social Security # *

Employed Full-Time? *

Yes No

Employer Name *

Hire Date *

Month Day Year

End Date

2nd Employer Name

End Date

Month Day Year

Monthly Gross Income

Mortgage, Rent, or Lease Payment

Address:

Time at residence?

Do you receive Disability income, SSI, Child Support, etc? *

Yes No

Other Monthly Income Amount

Upload Drivers License next to face. Example above.

By submitting this credit application, you certify that the information provided on the application is, to the best of your knowledge, complete and accurate. You understand that the Dealer and financial institution(s) will rely on this information to judge your credit worthiness, and will retain this application and information about you whether or not this application is approved. Further, you authorize an investigation of your credit and employment history, in conjunction with which your credit report(s) may be obtained from one or more consumer credit reporting agencies. You understand that false statements may subject you to criminal penalties. You further understand that the Dealer and/or the financial institution(s) that evaluate your application may require additional information.

FAIR CREDIT REPORTING ACT DISCLOSURE: You understand that the application for credit will be submitted by the dealer to various financial institutions for evaluation.

Enter the message as it's shown *

Proceed if all information is correct.

All information is accurate please continue processing for $ 16.99

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