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Finance
*
Denotes A Required Field.
Vehicle
Year
:
Make
:
Model
:
Stock Number
:
If Available.
Personal
Title
:
Mr.
Mrs.
Ms.
Dr.
First Name
:
M.I.
*
Last Name
:
*
SurName
:
Senior
Junior
II
III
IV
Drivers Lic. #
:
*
Social Sec. #
:
-
-
*
Birth Date
:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
*
Home Phone #
:
-
-
*
Email Address
:
*
Residence
Street Number
:
*
Direction
[North,West,etc.]
:
Street Name
:
AV
BL
CI
CT
DR
HY
LN
LP
PL
PW
RD
SQ
ST
SV
TE
TR
WY
*
Unit Type
[Apt.,Suite,etc.]
:
-- None --
Apartment
Suite
Unit
Unit #:
City
:
*
State
:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
[Postal Code]
:
*
By clicking "Accept / Submit", you submit and certify that all of the statements in this application are true and made for the purpose of obtaining credit. You authorize us to begin a credit investigation, including obtaining your consumer credit report, and to forward your application to lenders, financial institutions, or other third parties in order to process your application. We the Auto Dealer, may obtain information about you as described in this notice, which we handle as stated in this privacy policy notice. This does not apply to information obtained in a non-financial transaction. 1. We collect nonpublic personal information about you from the following sources: · Information we receive from you on applications or other forms in connection with a financial transaction; · Information about your transactions with us, our affiliates, or others; and · Information we receive from a consumer reporting agency. 2. We do not sell customer or consumer information to any third party. We may disclose the information we collect, as described above, to our affiliates, to other financial institutions with whom we have joint marketing agreements, or to companies that perform services or functions on our behalf. These companies may include financial service providers and non-financial companies such as computer and data processing companies, and marketing and aftermarket service providers. These companies will be contractually obligated to keep the information we provide them confidential and to use the information only to provide the services requested of them. We observe limits and restrictions set by law as to sharing of information with our affiliates or others. 3. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.
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