Credit Application
IMPORTANT: READ THESE DIRECTIONS BEFORE COMPLETING THIS APPLICATION
purchaselease
SECTION A.
Check appropriate box
If you are applying for individual credit in your own name and are relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit requested.If you are married and live in a community property state, complete all sections, including Section C, providing information about your spouse.If this is an application for joint credit with another person, complete all sections, providing information in Section C about the co-applicant.

NOTE: APPLICANT, IF MARRIED, MAY APPLY FOR A SEPARATE ACCOUNT.



SECTION B. Information Regarding Applicant













Applicant's gross monthly income from employment. (Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.)

Alimony, child support, or separate maintenance received under:
court orderwritten agreementoral understanding

SECTION C. Information Regarding Spouse, or Co-Applicant (if necessary)

Marital status
marriedunmarriedseparated





Co-applicant's gross monthly income from employment. (Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.)

Co-applicant alimony, child support, or separate maintenance received under:
court orderwritten agreementoral understanding


SECTION D. Asset and Debt Information: List all debts including alimony, child support, separate maintenance(Be specific & complete)
(If Section C has been completed, this section should be completed giving information about both the Applicant and the Co-Applicant, or other person. Please mark Applicant related information with an "A". If Section C was not completed, only give information about the Applicant in this Section)















Vehicles/Purchased from/Address/Purchase price/Monthly payment

Bank reference #1/Branch/Account number

CheckingSavingsLoan

Bank reference #2/Branch/Account number

CheckingSavingsLoan

Bank reference #3/Branch/Account number

CheckingSavingsLoan



HAVE YOU EVER HAD ANY PROPERTY REPOSSESSED?
YesNo
DO YOU HAVE ANY PENDING LAWSUITS??
YesNo
HAVE YOU FILED BANKRUPTCY IN THE LAST FOUR YEARS?
YesNo
MILITARY RESERVE?
YesNo
ACTIVE?
YesNo
INACTIVE?
YesNo

Name of friend #1/Address/City/State/Zip/Telephone

Name of friend #2/Address/City/State/Zip/Telephone

SECTION E. INSURANCE-IF YOU WISH TO APPLY FOR VEHICLE INSURANCE IN CONNECTION WITH THIS CREDIT APPLICATION, COMPLETE THE FOLLOWING:
Note: No person is required as a condition precedent to financing the purchase of a vehicle to purchase insurance through a particular insurance company, agent or broker.





Has your insurance ever been cancelled by any company?
YesNo





SECTION F. The undersigned (1) makes the above representations, which are certified to be correct, for the purpose of securing credit, (2) authorizes the Financial Institution to gather whatever credit and employment history it considers necessary and appropriate, and also approves the Financial Institution to give information concerning the transaction to others, and (3) understands that we will retain this application whether or not it is approved.

The Financial Institution named below may be requested to purchase a sales finance contract written, or to be written, in conjunction with your purchase. You are notified pursuant to the Fair Credit Reporting Act that your application may be submitted to them.




Name of FINANCIAL INSTITUTION/ADDRESS



PURCHASER HEREBY ACKNOWLEDGES RECEIPT OF A COPY OF THIS CREDIT APPLICATION/STATEMENT


X APPLICANT'S SIGNATURE

X OTHER SIGNATURE