CREDIT APPLICATION

Do Not use the back button!

This report cannot be processed unless all fields are filled out completely.

Primary applicant and joint applicant must complete seperate forms.

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Step 1 Information
If joint applicant, Please list primary applicant, and relationship.
First Name
Middle Name
Last Name
SSN	--
DOB	- 01 02 03 04 05 06 07 08 09 10 11 12 / - 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / mm/dd/yyyy
Address
Apartment	#
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
Time At Address	Years   Months
Rent Or Own	Buying Home Own Home Outright Rent Living with Relatives
Monthly Payment	$.00
Previous Address
Apartment	#
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
Time At Previous Address	Years   Months
Home Phone	() -
Cell Phone	() -
Best Place and Time To Call
Email
Confirm Email
Step 2 Employment Information Employer Name Job Title Employer Address Employer City Employer 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 Employer Zip Time Employed Years   Months Employer Phone ( ) -    Income $ .00 Gross Per Month (Before Taxes) Other Income $ .00 Gross Per Month (Before Taxes) Other Income Source Previous Employer Name Previous Employer City and State Time Employed Years   Months Step 3 Vehicle Information For Purchase Wanted Vehicle Make Acura AM General Aston Martin Audi Bentley BMW Buick Cadillac Chevrolet Chrysler Daewoo Dodge Ferrari Ford GMC Honda Hyundai Infiniti Isuzu Jaguar Jeep Kia Lamborghini Land Rover Lexus Lincoln Lotus Mazda Mercedes-Benz Mercury Mitsubishi Nissan Oldsmobile Plymouth Pontiac Porsche Rolls-Royce Saab Saturn Subaru Suzuki Toyota Volkswagen Volvo - Model Year 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983   Trade In Vehicle Make Acura AM General Aston Martin Audi Bentley BMW Buick Cadillac Chevrolet Chrysler Daewoo Dodge Ferrari Ford GMC Honda Hyundai Infiniti Isuzu Jaguar Jeep Kia Lamborghini Land Rover Lexus Lincoln Lotus Mazda Mercedes-Benz Mercury Mitsubishi Nissan Oldsmobile Plymouth Pontiac Porsche Rolls-Royce Saab Saturn Subaru Suzuki Toyota Volkswagen Volvo - Model Year 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 Mileage Payoff Amount $.00 Estimated Trade in Value $.00   Other Information Name of Bank Down Payment $.00 First Time Buyer NO    YES Bankruptcy NO    YES Repossession NO    YES Comments Please read ourPRIVACY NOTICE
BY SUBMITTING, I clearly understand that I am giving FOX VALLEY FORD permission to obtain a consumer credit report and to inquire via other parties to verify the information and credit information herein supplied. The information gathered is to initiate the process of purchasing or leasing a vehicle and FOX VALLEY FORD has a legitimate business need for the consumer credit report to complete the transaction if credit is granted.
By typing your name and date in the following spaces, you are agreeing to the disclosures above, including our privacy notice, and allowing us to run a check on your credit history.
Full Name
Date