Low Mileage Used Cars at the Nice Car Company

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Joint Applicant

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^{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

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Loan Requested

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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 creditros 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.

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