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] Credit Information | |
| 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__________________ | |