Fillable Printable Generic Credit Application Form
Fillable Printable Generic Credit Application Form
Generic Credit Application Form
FOR DEALER USE ONLY
CREDIT APPLICATION
APP #
FAIR CRE DIT REPORTING ACT TO CONSUMER
THIS WILL ADIVSE YOU THAT YOUR RETAIL INSTALLMENT SALES CONTRACT AND BUYER’S APPLICATION FOR SECURED DEBT WILL BE SUBMITTED TO FINANCIAL
INSTITUTIONS AND THEIR AFFILIATES FOR PURCHASE AND CONSIDERATION AS TO WHETHER YOU MEET THEIR CREDIT REQUIREMENTS.
THE UNDERSIGNED FURTHER AUTORIZES THESE FINANCIAL INSTITUTIONS AND THEIR AFFILIATES TO OBTAIN SUCH INFORMATION THAT THEY MAY REQUIRE IN
ORDER TO VERIFY INFORMATION RELATIVE TO THIS REQUEST INCLUDING CONTACTING SPOUSES TO VERIFY SPOUSE RELATED INFORMATION.
I CERTIFY THAT ALL INFORMATION GIVEN BY ME ON THIS APPLICATION IS COMPLETE AND ACCURATE. I GIVE MY PERMISSION FOR ANY FINANCIAL INSTITUTION
WHICH WILL REVIEW THIS CREIDT APPLICATION, TO INVESTIGATE MY CREDIT AND EMPLOYMENT HISTORY, AND TO ANSWER QUESTIONS ABOUT THEIR CREDIT
EXPERIENCE WITH ME INCLUDING BUT NOT LIMITED TO LATE PAYMENTS, MISSED PAYMENTS OR OTHER DEFAULTS, AND THIS INFORMATION MAY BY REPORTED
IN YOUR CREIDIT REPORT.
APPLICANT
SIGNATURE _______________________________________________
REQUIRED DATE
(A) APPLICANT Driver’s License No. __ ___________________ _______
JOINT APPLICANT
SIGNATURE _______________________________________________
REQUIRED (means you intend to apply for joint credit) DATE
(B) J O INT APPLICANT Driver’s License No. ______ ________________
(A) APPLICANT INFORMATION (B) JOINT APPLICANT INFORMATION
PRINT FULL NAME PRINT FULL NAME
DOB SSN # OF DEPENDENTS DOB SSN # OF DEPENDENTS
STREET ADDRESS STREET ADDRESS
CITY STATE ZIPCODE CITY STATE ZIPCODE
HOW LONG? HOME PHONE CELL PHONE HOW LONG? HOME PHONE CELL PHONE
RESIDENTIAL STATUS MONTHLY RENT/MORTGAGE PMT RESIDENTIAL STATUS MONTHLY RENT/MORTGAGE PMT
LANDLORD OR MORTGAGE HOLDER’S NAME LANDLORD OR MORTGAGE HOLDER’S NAME
PREVIOUS ADDRESS (if less than 2 yrs at current address) PREVIOUS ADDRESS (if less than 2 yrs at current address)
CURRENT EMPLOYER’S NAME CURRENT EMPLOYER’S NAME
CURRENT EMPLOYER’S ADDRESS CURRENT EMPLOYER’S ADDRESS
GROSS MONTHLY SALARY WORK PHONE GROSS MONTHLY SALARY WORK PHONE
OCCUPATION/JOB TITLE HOW LONG? OCCUPATION/JOB TITLE HOW LONG?
PREVIOUS EMPLOYER (if less than 2 yrs on current job) HOW LONG? PREVIOUS EMPLOYER (if less than 2 yrs on current job) HOW LONG?
OTHER INCOME NOTE: Alimony, child support, or separate maintenance incomes do not have to be revealed unless the applicant wishes to have
such sources considered as a basis for repayment of the requested credit amount.
GROSS MONTHLY OTHER INCOME OTHER INCOME SOURCE GROSS MONTHLY OTHER INCOME OTHER INCOME SOURCE
REFERENCE 1 PHONE ADDRESS RELATIONSHIP
REFERENCE 2 PHONE ADDRESS RELATIONSHIP
NEW USED DEMO YEAR MAKE BOOK VALUE
MODEL BODY STYLE MILEAGE
TRADE IN YEAR MAKE MODEL LIENHOLDER
TERM RATE AMOUNT DEALER (UNDERWRITER)
CASH SELLING PRICE ___________
NET TRADE ___________
CASH DOWN ___________
UNPAID BALANCE ___________
PLUS INSURANCE & FEES ___________
TOTAL AMOUNT FINANCED ___________
