Auto Dealership Loan Application

Application Preferences

Dealership Name*:

Dealership Fax*:

Dealership Phone*:

Select a Vehicle Condition*:

Do You Have a Trade In?*:

Is There a Joint Applicant?*:

Note: If the applicant resides in a community property state and is married, you may consider adding the personal credit information of that spouse. The spouses information is not required to be entered as a co-applicant unless he/she wants to be considered for the loan.

Applicant's Personal Credit Information

First Name / MI*:    

Last Name*:

Social Security Number*:

Date of Birth (mm/dd/yyyy)*:

Home Phone*:

Cell Phone:

Address 1*:

Address 2:



Zip Code*:

Time at Address*:
yrs.     months

Housing Status*:

Mortgage / Rent Payment (Monthly)*:

Applicant's Employment History

Employment Status*:

Employed By*:


Time Employed*:
yrs.     months

Salary Gross (Monthly)*:

Business Phone*:

Note: 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.

Other Income (Monthly):

Source of Income:

Phone Number if Applicable:

Financial / Collateral Information

Stock Number:

VIN Number*:

Vehicle Year*:

Vehicle Make*:

Vehicle Model*:

Vehicle Trim:

Invoice / MSRP: /

Book Trade / Retail NADA Clean trade (hard adds only): /

Odometer Mileage*:

Additional Comments: