Credit Application2

 

All fields are required

c
Date
Type of Loan Individual
Joint
Full Name
Social Security Number
Date of Birth
Number of Dependents
Address
City
State
Zip Code
Phone Number
How Long at Residence
  Own
Rent
Live With Parents

Other Please Explain
Previous Address if at current address less than 3 years (If no, skip the next three lines)
Previous City
Previous State
Previous Zip Code
Name of Employer
Employers Address
Employers Phone Number
Position
Department
Salary: Select Week, Month, or Other Below
 

 

Week
Month
Other
Date Employed
Previous employer if at present less the 3 years (If no, skip the next three lines)
Position
Salary: Select Week, Month, or Other Below

 

Week
Month
Other
Time Employed at previous job in years and months

                                 Other Income:

(Income from alimony, child support or maintenance payments need not be revealed if the applicant does not choose to disclose such income in applying for this credit) Monthly
Source , If source is alimony, child support, or maintenance payments provide the following information in addition to the information under spouse below: Payments are received pursuant to a ()written agreement, ()court decree, ()neither.  Length of time the payments have been received regularity of receipt .
 

Car I am applying for:

 

Year
Make
Model
Type of Body
Stock Number (Example BOB1234)
Cash Down
Months Requested
 

Complete the below section ONLY IF (a) the spouse will be contractually liable for repayment; (b) the applicant is relying on alimony, child support or maintenance payments from a spouse or former spouses as a basis for repayment of the loan requested.

   
Joint Applicant
Social Security Number
Date of Birth
Complete only if loan is secured: Married
Unmarried
Separated
Name of Employer
Employers Address
Employers Phone Number
Position
Department
Salary Select Week, Month, or Other Below
  Week
Month
Other
Date Employed
Previous employer if at present less than 3 years
Position
Salary at previous job
  Week
Month
Other
Time Employed
Customers nearest relative other than spouse
Relationship
Address
Phone Number
Name of your bank
  Checking
Savings
Landlord or mortgage holder
Address
Terms