Financing For Your New Vehicle

First Name:

Last Name

Social Security Number

Drivers License Number

Drivers License State

Date of Birth

Email Address

Home Phone Number

Cell Phone Number

Preferred Contact Method

Bank Name

Street Address

City

State

Zip Code

Residence Type

Monthly Rent/Mortgage Payment

Mortgage Company

Time at Residence

Employer

Occupation

Monthly Income

Time on Job

Work Phone Number

Work Address

Work City

Work State

Work Zip

Source

Amount

Type of Vehicle

Your Salesperson, if any

Additional Comments

For the purposes of securing credit from you, I certify that the above information is true and complete to the best of my knowledge. I further certify that I have attained the age of majority. I authorize you to check my credit and employment history and to provide and/or obtain information about credit experience with me. I also agree to the privacy notice located at the bottom of this page.

Signature

In connection with your transaction, Nice Car Company. may obtain information about you as described in this notice, which we handle as stated in this notice.

1. We collect nonpublic personal information about you from the following sources:

• Information we receive from you on application or other forms;
• Information about your transaction with us, our affiliates or other; and
• Information we receive from a consumer reporting agency.

2. We may disclose all of the information we collect, as described above, to companies that perform marketing services on our behalf or to other financial institutions with whom we have joint marketing agreements. We may make such disclosures about you as a consumer, customer, or former customer.

3. We may also disclose nonpublic personal information about you as a consumer, customer, or former customer, to non-affiliated third parties as permitted by law.

4. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.