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| Name:__________________________________________________________________________ | Birthdate (M/D/Y)____________ | ||
| Address_________________________________________________________________________ | Sin #______________________ | ||
| _______________________________________________________________________________ | How Long__________________ | ||
| Previous Address:__________________________________________________________________ | How Long__________________ | ||
| _______________________________________________________________________________ | Martial Status_______________ | ||
| Home Phone #___________________Work Phone #_____________________________________ | Driver's License______________ | ||
| Mort/Rent Payment:_______________Mort. Amt._______________________________________ | Property Value______________ | ||
| Mortgage/Landlord Name___________________________________________________________ | Phone #___________________ | ||
| Employer_______________________Address:__________________________________________ | |||
| Job Title:_______________________Job Tittle:_________________________________________ | Gross Income Monthly________ | ||
| Previous Employer:________________________________________________________________ | How Long__________________ | ||
| Additional Income:________________________________________________________________ | |||
| Debts, Credit Cards Etc._____________________________________________________________ | |||
| Bank:___________________________________________________________________________ | Branch Acc.#_______________ | ||
| Have you been declined for credit?______YES / NO_________WHY?_________________________ | |||
| _______________________________________________________________________________ | |||
| Vehicle Info - Year________________________________________________________________ | Serial #____________________ | ||
| Make:_________________________Specific Model:______________________________________ | |||
| New/Used_____KMs_____________ Options:___________________________________________ | |||
| Selling Price:____________________Cash Down/Trade:___________________________________ | |||
| Amount To Finance:_______________Term____________________________________________ | Max Mon. Payments__________ | ||
| Black Book Price:________________Clean/Avg_________________________________________ | |||
| I
certify that the above
information is complete and accurate, and i authorize an investigation of my credit history and the release of information about my credit experience. |
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DATE:________________APPLICANT:____________________CO-APPLICANT___________________
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