| 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. |
| DATE:________________APPLICANT:______________________CO-APPLICANT____________________ |