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Privacy Notice to our Customers
In
connection with your transaction, this dealership may obtain information
about you as described in this notice, which we handle as stated
in this notice.
We
collect non-public personal information about you from the
following sources
Information
we receive from you on applications or other forms;
Information
about your transactions with us, our affiliates or others;
and,
Information
we receive from a consumer reporting agency.
We
may disclose all the information we collect, as described
above, to companies that perform marketing services on our
behalf or to other financial institutions with whom we have
joint marketing agreements. We may make such disclosures about
you as a consumer, customer or former customer.
We
may also disclose non-public personal information about you
as a consumer, customer, or former customer, to non-affiliated
third parties as permitted by law.
We
restrict access to non-public personal information about you
to those employees who need to know that information to provide
products or services to you. We maintain physical, electronic,
and procedural safeguards that comply with federal regulations
to guard your non-public personal information.
Online
Credit Application
Individual Application
Joint Application
Applicant Information
Co Applicant Information
Title:
Mr.
Mrs.
Ms.
Name:
Social Security Number:
Date of Birth (Month, Day, Year):
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
1985
1986
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
Married
Single
Separated
Email Address:
Phone Numbers:
Daytime Phone:
Evening Phone:
Best Time to Call:
How would you like us to contact you:
Day Phone
Evening Phone
E-Mail
Address Information
Current Street Address:
City:
State:
Zip:
Own
Rent
How Long Current Address
Monthly Rent or Mortgage Payment
Previous
Address
(if less than 5 years)
City:
State:
Zip:
How Long at Previous Address
Level
of Education
High School Graduate
Some College
Two Years College
College Graduate
Past
Credit History
Have
you ever filed Bankruptcy?
Yes
No
If Yes, When:
Have you ever had anything repossessed?
Yes
No
If Yes, What:
Employment
Information
Employer:
Work Phone Number:
Work Address:
Work City, State & Zip
Occupation:
How Long:
Gross Monthly Income:
Previous Employer (if less than 5 years):
How Long at Previous Employer:
Additional Income:
Source of Additional Income:
Alimony, child support, or separate maintenance income
need not be revealed if you do not wish to have it considered
as a basis for repayment.
Title:
Mr.
Mrs.
Ms.
Name:
Social Security Number:
Date of Birth (Month, Day, Year):
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
1984
1985
1986
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
Married
Single
Separated
Email Address:
Phone Numbers:
Daytime Phone:
Evening Phone:
Best Time to Call:
How would you like us to contact you:
Day Phone
Evening Phone
E-Mail
Address Information
Current Street Address:
City:
State:
Zip:
Own
Rent
How Long Current Address
Monthly Rent or Mortgage Payment
Previous
Address
(if less than 5 years)
City:
State:
Zip:
How Long at Previous Address
Level
of Education
High School Graduate
Some College
Two Years College
College Graduate
Past
Credit History
Have
you ever filed Bankruptcy?
Yes
No
If Yes, When:
Have you ever had anything repossessed?
Yes
No
If Yes, What:
Employment
Information
Employer:
Work Phone Number:
Work Address:
Work City, State & Zip
Occupation:
How Long:
Gross Monthly Income:
Previous Employer (if less than 5 years):
How Long at Previous Employer:
Additional
Income:
Source of Additional Income:
Alimony, child support, or separate maintenance income
need not be revealed if you do not wish to have it considered
as a basis for repayment.
How Much Cash Down:
Year:
Make:
Model:
Comments:
Vehicle Stock Number If Known:
Additional Information that may
help during
our review process (maximum 250 characters)
Both
of the following items must be checked for us to complete this
request!
For the purpose of securing credit from you, I certify that
the above information is true and complete to the best of my
knowledge.
I give the above information for the purpose of obtaining credit
and I authorize you and any affiliate to verify this information,
including obtaining credit bureau report(s)
WARNING:
Falsification of your identification is fraud and will be prosecuted
to the fullest extent of the law.
I
understand this application is subject to final credit approval
at the dealership.
By
submitting this completed form, I acknowledge that I have read
and understand the disclosures.