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Credit Application

Dealership Information

Location / Dealership Name

Salesperson

How did you hear about us?

Personal Information

First Name

Middle Name

Last Name

Email Address

Cell Phone Number

Home Phone Number

Work Phone Number

Date of Birth

SSN / ITIN number

ID Type

ID State

ID Number

Issue Date

Expiration Date

Down Payment

Current Employment

Employer

Street

Zip

City

State

Pay Period

Income Per Paycheck

Monthly Net Income

Your Position at Work

Supervisor Name

Start Date

Second Job or Other Income

Employer

Monthly Net Income

Start Date

Please enter 3 year(s) of residence history

Current Residence

Street

Zip

City

County

State

Household

Move In Date

Monthly Rent / Mortgage Payment

Landlord Name

Landlord Phone Number

Previous Residence 1

Street

Zip

City

County

State

Household

Move In Date

Move Out Date

Monthly Rent / Mortgage Payment

Electronic Signature Disclosure

I agree and certify that all the information in my application is complete and true. I authorize Car Credit Nation and Car Credit Finance to investigate my credit, residential history and employment history, obtain my credit reports, and release information about their credit experience with me. If an account is created, I authorize the obtaining of credit reports for purposes of reviewing or taking collection action on the account or for the other legitimate purposes associated with the account. I agree that you and any assignee of the financing contract or lease may monitor and record telephone calls regarding my account to assure quality of service or for other reasons. I agree that you and assignee of the contract may try to contact me in writing by email, or using prerecorded/artificial voice messages, or text messages, as the law allow. I also agree that you and any assignee of the financing contract may try to contact me in these other ways at any address or telephone number I provide, even if the telephone number is a cell phone or the contact results in a charge to me. I agree to the Privacy Policy , Pre-Sale Arbitration Agreement , and that I may be contacted by Car Credit Nation or Car Credit Finance in regards to my application. Under Federal Law by the Federal Trade Commission (FTC) you have a right to know your credit score, how your credit score is obtained, the range of scores your score falls in and how it compares to scores of other consumers. This information will be found on the Risk Based Pricing Notice. By agreeing to electronically apply for credit, you are acknowledging and agreeing that the Risk Based Pricing Notice will be delivered to you by mail to the address provided on the credit application if you do not come into the dealership for your physical copy.

Electronic Signature
First and Last Name must match exactly as entered above