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APPLICATION FOR CREDIT
This is an application for credit with Dealer. You understand there is no agreement
between us until we approve your credit application and accept all other required
documents for funding.
PLEASE PRINT CLEARLY AND COMPLETE ALL REQUESTED INFORMATION
OTHER 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 repaying this obligation.)
PERSONAL REFERENCES (not in same household)
OPTIONAL ACH (AUTOMATIC WITHDRAWALS)
By signing this application you promise all information is true and complete. You
intend the seller and/or assignee to rely upon this information in deciding whether
or not to extend credit to you. You authorize a full investigation and release of
your credit record and your employment history. You also authorize the seller and/or
assignee to release information about credit experience with them. You consent to
receiving autodialed or prerecorded messages from us or those acting on our behalf
at any mobile telephone number you provide to us.
CREDIT REPORT NOTICE: We may request a credit report for any legitimate purpose associated
with your application for credit, extending credit, modifying the terms of your credit
agreement, or collection on your account. On your request, we will inform you if
such a report was ordered and will give you the name and address of the credit reporting
agency that furnished the report.
ALABAMA AND NEBRASKA RESIDENCE: You must be 19 years old to apply for credit.
CALIFORNIA RESIDENTS: If married, you may apply for a separate account.
NEW YORK RESIDENTS: We may obtain your credit report and we will inform you, upon
request, whether a report was obtained and, if so, the name and address of the consumer
OHIO RESIDENTS: The Ohio laws against discrimination require that all creditors make
credit equally available to all credit worthy customers, and that credit reporting
agencies maintain separate credit histories on each individual upon request. The
Ohio civil rights commission administers compliance with this law.
VERMONT RESIDENCE: We may obtain your credit reports at any time, for any legitimate
purpose associated with the account or the application or request for an account,
including bit not limited to reviewing, modifying, renewing and collecting on your
account. On your request we will inform you if such a report was ordered. If so,
we will give you the name and address of the consumer reporting agency furnishing
WISCONSIN NOTICE TO MARRIED APPLICANTS: No provision of any marital property agreement,
unilateral statement under Wis. Stats. 766.59, or court decision under Wis. Stats.
766.70 adversely affects the interest of the creditor unless the creditor is furnished
a copy of the decree, agreement, statement, or has actual knowledge of the adverse
provision prior to the time credit is granted.
Rent / Mort. Pmt.
How Long at address? Months
I (we) hereby authorize lender or any assignee to initiate debit entries to the below-listed
account for my monthly payments. This authorization remains in full force end effect
until the lender/assignee has received written notification from me (us) in such
time and such manner as to afford lender/assignee a reasonable opportunity to act
on it. Please allow 10 days for all changes to be effective.
**PLEASE ATTACH A VOIDED CHECK OR DEPOSIT SLIP**
Must print your name as it appears on your driver license in the below box.
APPLICANT ELECTRONIC SIGNATURE
CO-APPLICANT ELECTRONIC SIGNATURE
Attach a File
Enter the Security Code Listed
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