Finance Application

Applicant

First Name*
Middle Init
Last Name*
 
Social Security No.*
 
D.O.B.*
Address*
Apt/Unit
City*
State*
Zipcode*
Home Phone*
 
Cell Phone
 
Work Phone
Residence
 
Monthly Payment
 
How Long
Previous Address* if less than 3 years
Prev. Apt/Unit
Prev. City*
Prev. State*
Zipcode*
How Long
Employer*
 
Occupation
 
Gross Annual Pay*
 
How Long
Previous Employer* (if less than 3 yrs)
 
Occupation
 
Gross Annual Pay
 
How Long
Other Income
 
Source
 
Nearest Relative
 
Phone

Joint Applicant

First Name*
Middle Init
Last Name*
 
Social Security No.*
 
D.O.B.*
Address*
Apt/Unit
City*
State*
Zipcode*
Home Phone*
 
Cell Phone
 
Work Phone
Residence
 
Monthly Payment
 
How Long
Previous Address* if less than 3 years
Prev. Apt/Unit
Prev. City*
Prev. State*
Zipcode*
How Long
Employer*
 
Occupation
 
Gross Annual Pay*
 
How Long
Previous Employer* (if less than 3 yrs)
 
Occupation
 
Gross Annual Pay
 
How Long
Other Income
 
Source
 
Nearest Relative
 
Phone

Collateral

Year
 
Make
 
Model
 
Mileage
Description of Options
 
Term

Loan Requested

Cash Price (including tax, title, fees)
 
Trade-In Value
Cash Down
 
Amount Owed
Unapid Balance to Finance
 
Net Trade Value

Disclaimer

Applicant Release*

 I agree to the following*

- I am at least 18 years old and a permanent resident of the United States

- I authorize this dealership to obtain a credit report in connection with our review of your credit application.

- I understand that this dealership may call me in connection with this application

- I have reviewed the dealerships privacy policy

Co-Applicant Release*

 I agree to the following*

- I am at least 18 years old and a permanent resident of the United States

- I authorize this dealership to obtain a credit report in connection with our review of your credit application.

- I understand that this dealership may call me in connection with this application

- I have reviewed the dealerships privacy policy



OHIO EQUAL CREDIT OPPORTUNITY NOTICE: "The Ohio law against discrimination requires that all creditors make credit equally available to all creditworthy 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." By signing below, "Applicant" (applicant, co-applicant and/or co-signer) certifies that all information submitted herein is true, accurate and complete and that there are no other obligations other than those itemized on this application or attached hereto. Applicant authorizes Bank to verify employment information and to obtain and/or exchange whatever credit information Bank deems necessary in processing, review or collection of credit applied for or extended in connection with this application, and to refer this application to any affiliate of Bank. This authorization extends to other creditors receiving this application. THE UNDERSIGNED FURTHER WARRANTS THAT A BANKRUPTCY PROCEEDING IS NEITHER PRESENTLY IN PROGRESS NOR ANTICIPATED. You are authorized to recognize my signature appearing below in connection with all matters pertaining to said loan.