CREDIT APPLICATION

Primary Applicant Info
1. I will be applying:
Individually With a Co-Applicant
2. First Name:
 MI:
 Last Name:
 Suffix:
   Additional Surname (if known by two surnames)
3. Social Security Number:
- -
4. Date of Birth:
/ /
(mm) /  (dd) /  (yyyy)
2

Contact numbers where you can be reached:
1 - ()- -    Contact Type: Other    Home Phone    Cell/Mobile    Pager
2 - ()- -    Contact Type: Other    Home Phone    Cell/Mobile    Pager

3 - ()- -    Contact Type: Other    Home Phone    Cell/Mobile    Pager

6. Email Address:

.
7. Current Address:  
  Street:
   
  City:    State:
  Zip:
  I have a separate mailing address.
7b. Mailing Address:
  Street:  
   
  City:    State:
  Zip:
   
8. How long have you been at your current address?
Years     Months
 
   
8b. Previous Address: (If less than 2 years at current address)
  Street:  
  City:   State:
  Zip:
  How long?   Years   Months
9. Do you own property? If you own property, or are paying a mortgage on one, select 'yes'. Property includes a primary residence, second home, rental property, or vacant lot.
Yes     No    

 
10. What vehicle do you want?
11. What is your Gross Monthly Salary? Net Monthly Salary includes net pay (income after taxes and standard deductions, except payroll deductions), rental income, alimony and child support. You do not have to include alimony, child support or separate maintenance income unless you want us to consider it in connection with this application.
$
12. Do you have a checking and/or a savings account?
Checking     Savings     Both     No
13. Do you currently own a car/truck/suv?
Yes     No
14. Are you currently retired?
Yes     No
15. Who is your current employer? (if retired, last employer)
  
16. How long have you worked for this employer?
Years   Months 		 
   
15b. Previous Employer (If less than 2 years at current employer)
16b. How long did you work for this employer?
Years   Months

Co-Applicant Info

1. First Name:
 MI:
 Last Name:
 Suffix:
   Additional Surname (if known by two surnames)
2. Social Security Number:
- -
3. Date of Birth:
/ /
(mm) /  (dd) /  (yyyy)
4. Contact number:
1 - ()- -    Contact Type: Other    Home Phone    Cell/Mobile    Pager
5. Current Address: Same As Applicant
  Street:
  City:   State:      Zip:
6. How long have you been at this address?
Years   Months
7. What is your Gross Monthly Salary? Net Monthly Salary includes net pay (income after taxes and standard deductions, except payroll deductions), rental income, alimony and child support. You do not have to include alimony, child support or separate maintenance income unless you want us to consider it in connection with this application.
$
8. Are you currently retired?
Yes     No
9. Who is your current employer? (if retired, last employer)
10. How long have you worked for this employer?
Years   Months