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Credit Application

David Cates
Operations Manager

Awards
 

GOLD Level
Certified

Ed Wilm
Business Manager

Business Manager
Association
I am applying: Alone
With a Co-applicant
As a Co-signer
 
*What Vehicle are you interested in?
Year:
Make:
Model:
Stock No.:
Who is your salesperson?
Tell us about your Trade-in:
Year:
Make:
Model:
Condition:
Miles:
 
   
Monthly Payment: $ .00
Lien Holder:
Balance Due (estimate): $ .00
 
Information About Me
Information About My Co-applicant
Contact Information:

*Full Name:
 
*Social Security #:
 

Date of Birth:
Address:

City:

State:

Zip:
*Home Phone
 

Business Phone

 
Residential Status:

Own Rent Other

Monthly Payment: $   .00
Time at this address:   **

**If less than 3 years, please enter your previous address below:
Address:
 
City:
 
State:
 
Zip:
 

 
Income & Employment Status:

Monthly Gross Income: $   .00
Current Employer:
 

Position or Title:
 

Address:

City:

State:

Zip:

Time at this employer: ***

***Previous employer, & address (if you have worked for this employer less than 3 years):
Address:

City:

State:

Zip:

Position or Title:

Monthly Gross Income:
$ .00


 
Contact Information:

*Full Name:

*Social Security #:

Date of Birth:

Address:

City:

State:

Zip:

Home Phone

Business Phone

 
Residential Status:

Own Rent Other

Monthly Payment: $ .00
Time at this address: **

**If less than 3 years, please enter your previous address below:
Address:

City:

State:

Zip:

 
Income & Employment Status:

Monthly Gross Income: $ .00
Current Employer:

Position or Title:
 

Address:

City:

State:

Zip:

ime at this employer: ***

***Previous employer, & address (if you have worked for this employer less than 3 years):
Address:

City:

State:

Zip:

Position or Title:

Monthly Gross Income:
$ .00


 

Additional Information:

I do not have to reveal alimony, child support, food stamps, or maintenance income unless I wish it to be considered as a basis for repayment.

Bank Reference (mine or co-applicant's)

Checking Savings Credit line Loans
Bank reference (name and address)
 Checking Savings Credit line Loans
   

Credit Obligations: I will include those of my co-applicant if different from my own.?

Type Creditor's Name Monthly Payment Balance Outstanding Type Creditor's Name Monthly Payment Balance Outstanding
Auto Loan Auto Loan

I certify that I have read the Privacy Notice, and that the information stated in this Credit Application is true, correct to the best of my knowledge, and a complete statement of my financial condition. I understand that the Credit Application will be kept whether or not my credit request is approved. You and any prospective or subsequent creditor connected with this credit request are authorized to check my credit, employment, and income history and state records, including State Employment Security Agency records, and to disclose credit information to each other and to answer questions from others about your credit experience with me. Information about me may be shared among Norwest backs and companies, but I may bar such sharing of certain information as disclosed on the reverse side.

As Applicant, I hereby understand that by filling our names in the signature fields below, and by pressing the "Submit" button below, we are signing a legal document and do attest to the accuracy of the information provided herein.


The following information MUST be filled out for the credit application to be submitted.
 

*Yes I understand

*Applicant's signature:
 
*Date:
 
*E-Mail Address:
 

Co-applicant's signature:

Date:

 

 
 
     
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