HTML Preview Lease Credit Purchase Application Form page number 1.
PURCHASE OR LEASE CREDIT APPLICATION
The undersigned jointly and severally (1) certify the above information to be accurate and complete and intend it be relied upon to judge creditworthiness; (2) agree that this application and all related information may be indefinitely retained whether or not credit is extended;
(3) certify that the vehicle will not be used for any illegal or restricted purpose; (4) authorize consumer credit reports and investigations of asset, debt, and employment history to be obtained in connection with this application and for any update, review, collection, renewal or
extension of the credit received; (5) authorize the exchange of credit, account and financial information about the undersigned, AND UNLESS THE CIRCLE THAT FOLLOWS IS MARKED, AUTHORIZE THE DEALER AND ANY ASSIGNEE OR OTHER PERSON TO WHOM THIS
APPLICATION IS SUBMITTED TO SHARE AND USE INFORMATION ABOUT ME, INCLUDING INFORMATION IN MY APPLICATION, WITH OTHER ENTITIES THAT ARE RELATED TO THEM BY COMMON OWNERSHIP OR AFFILIATED WITH THEM BY COMMON CONTROL. IF
THE CIRCLE IS MARKED, I DIRECT THE DEALER AND ANY ASSIGNEE OR OTHER PERSON TO WHOM THIS APPLICATION IS SUBMITTED NOT TO GIVE INFORMATION TO SUCH ENTITIES (OTHER THAN INFORMATION ON THEIR OWN TRANSACTIONS AND
EXPERIENCES) ; (6) agree to be solely responsible for making arrangements for delivery of communications to be provided to the undersigned in connection with this application; and,
(7) I ALSO ACKNOWLEDGE RECEIPT OF A COPY OF THIS APPLICATION.
APPLICANT'S SIGNATURE DATE DATE
IMPORTANT: BEFORE COMPLETING THIS FORM, READ THE DIRECTIONS
CAREFULLY: (Check appropriate box at right):
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have them
considered as a basis for repaying this obligation.
Please complete SECTION B only if you checked one or more of the boxes to the right.
NOTE: APPLICANT, IF MARRIED, MAY APPLY FOR A SEPARATE ACCOUNT.
The vehicle is being purchased for the use of another person instead of, or in addition to, me, the applicant. Thus, the other person is
included as co-applicant.
I, the applicant, am married and live in California or another community property state. Thus, information about my spouse is included.
I, the applicant, intend to rely in whole or in part on the assets or income of another person, the co-applicant, for repayment.
I, the applicant, am applying for credit in my name only, relying only on my own assets and income. None of the 3 checkbox items
below apply to me.
SECTION A. APPLICANT INFORMATION
AGES OF DEPENDENTS
HOW LONG?
SECTION B. SPOUSE/CO-APPLICANT INFORMATION (Use additional sheet if necessary.)
MARRIED
I
N
C
O
M
E
UNMARRIED
SEPARATED
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, separate maintenance received under: Amount $
Amount of other monthly income and source(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
court order written agreeme verbal underestanding
Mos.Yrs.
LAST NAME FIRST INITIA BIRTHDATE DRIVER'S LICENSE NO. SOCIAL SECURITY NO.
ADDRESSES CITY STATE ZIP HOME PHONE
Mos.Yrs.
LIVED IN COMMUNITY?
ZIPSTATECITYPREVIOUS ADDRESSES (TO COVER 5 YEARS RESIDENCE)
HOW LONG?
Mos.Yrs.
CITY STATE ZIP
HOW LONG?
Yrs. Mos.
LIVED IN COMMUNITY?
Yrs. Mos.
OCCUPATION OR RANK CITY STATE ZIP
HOW LONG?
Yrs. Mos.
PRESENT EMPLOYER ADDRESSES PHONE
Mos.Yrs.
HOW LONG?
PHONEZIPSTATECITYADDRESSESPREVIOUS EMPLOYMENT (TO COVER 5 YEARS HISTORY)
ADDRESSES CITY STATE ZIP PHONE
Mos.Yrs.
HOW LONG?
RELATIONSHIPZIPSTATECITYADDRESSESNEAREST RELATIVE NOT LIVING WITH APPLICANT
RELATIONSHIPZIPSTATECITYADDRESSESPERSONAL FRIENDS KNOWN OVER ONE YEAR PHONE
PHONE
TOTAL MONTHLY INCOME $
SECTION C. Asset and Debt Information: List All Debts Including Alimony, Child Support, Separate Maintenance. (Use a Separate Page If Necessary.)
AGES OF DEPENDENTS
HOW LONG?
MARRIED
I
N
C
O
M
E
UNMARRIED
SEPARATED
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, separate maintenance received under: Amount $
Amount of other monthly income and source(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
court order written agreeme verbal underestanding
Mos.Yrs.
LAST NAME FIRST INITIA BIRTHDATE DRIVER'S LICENSE NO. SOCIAL SECURITY NO.
ADDRESSES CITY STATE ZIP HOME PHONE
Mos.Yrs.
LIVED IN COMMUNITY?
ZIPSTATECITYPREVIOUS ADDRESSES (TO COVER 5 YEARS RESIDENCE)
HOW LONG?
Mos.Yrs.
CITY STATE ZIP
HOW LONG?
Yrs. Mos.
LIVED IN COMMUNITY?
Yrs. Mos.
OCCUPATION OR RANK CITY STATE ZIP
HOW LONG?
Yrs. Mos.
PRESENT EMPLOYER ADDRESSES PHONE
Mos.Yrs.
HOW LONG?
PHONEZIPSTATECITYADDRESSESPREVIOUS EMPLOYMENT (TO COVER 5 YEARS HISTORY)
ADDRESSES CITY STATE ZIP PHONE
Mos.Yrs.
HOW LONG?
RELATIONSHIPZIPSTATECITYADDRESSESNEAREST RELATIVE NOT LIVING WITH APPLICANT
RELATIONSHIPZIPSTATECITYADDRESSESPERSONAL FRIENDS KNOWN OVER ONE YEAR PHONE
PHONE
TOTAL MONTHLY INCOME $
(If Section B has been completed, this Section should be completed giving information about both the Applicant and Joint Applicant or Other Person. Please mark Applicant-related information with an "A". If Section B
was not completed, only giveinformation about the Applicant in this Section.)
CITY ACCOUNT NO.
CURRENT MARKET VALUE
CITY STATE ZIPTYPE OF CREDIT
CITY STATE ZIP
COMPANY NAME OF ALL OBLIGATIONS
ADDRESSES
ADDRESSES CITY STATE ZIPPRESENT VEHICLE FINANCED BY / LEASED BY:
ZIPSTATECITYBRANCH / ADDRESS
MONTHLY PYMTS
OR DATE CLOSED
HAVE YOU EVER HAD ANY
PROPERTY REPOSSESSED?
MILITARY RESERVE?
DO YOU HAVE ANY LAW SUITS
PENDING AGAINST YOU?
HAVE YOU EVER FILED BANKRUPTCY OR IS A BANKRUPTCY
PROCEEDING IN PROGRESS OR EXPECTED?
LANDLORD OR MORTGAGE HOLDER
ADDRESSES
DATE OF PURCHASE AGE OF HOME PURCHASE PRICE OF HOME
MORTGAGE BALANCE PAYMENT OR RENT
2nd MORTGAGE AMOUNT
PAYMENT
$ $
$
$
$$
HIGHBALANCEADDRESSESACCOUNT NO.
OPEN CLOSED
$ $ $
$
BALANCE
$
HIGH
$
OPEN CLOSED
OWN RENT
BANK REFERENCE
ACCOUNT NO.
ACCOUNT NO.
$
$
BLANCE
SAVINGCHECKING
YES
NO
YES
NO
YES
NO
YES
NO
ACTIVE
INACTIVE
INSURANCE: If you would like to apply for vehicle insurance in connection with this credit application, complete the following:
NOTICE: The purchase of insurance through a particular insurance company, agent, or broker is not a condition to financing.
MOST RECENT INSURANCE CO. OR AGENT (NAME AND ADDRESS) PHONE WHERE WILL VEHICLE BE GARAGED? POLICY NO.
Has your insurance ever been
cancelled by any company?
YES
NO
IF YES, WHY? NO. OF INSURANCE LOSSES IN PAST 5 YEARS TOTAL AMOUNT OF LOSSES
$
FAIR CREDIT REPORTING ACT DISCLOSURE: This application for credit may be submitted by the dealer to various financial institutions, including those listed below,in connection with possible purchase or
authorization of a vehicle contract. Upon request, names of other institutions receiving this application will be provided.Financial Institution(s) and Address(es):
CO-APPLICANT'S SIGNATURE