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Applicant Information

First Name: Last Name
Address:
City: State: Zip:
Home Phone: Best Time to Reach You:
Cell Phone: Best Time to Reach You:
Work Phone: Best Time to Reach You:
Do you have an Oklahoma Drivers License?
Yes No
Do you live within 50 miles of Oklahoma City Metro Area?
Yes No
On current Job more then 7 months?
Yes No
Have paycheck stub for proof of income?
Yes No
Number of Repos?
Have You Lived in Oklahoma More then 2 years?
Yes No

INCOME
Monthly Take Home Pay: $ .00

By submitting this credit application, I/we certify that the information provided by this application is, to the best of my/our knowledge, complete and accurate. I/we understand that the Dealer and financial institution(s) will rely on this information to judge my/our credit worthiness, and will retain this application and information about me/us whether or not this application is approved. Further, I/we authorize an investigation of my/our credit and employment history, in conjunction with which my/our credit report(s) may be obtained from one or more consumer reporting agencies. I/we understand that false statements may subject me/us to criminal penalties. I/we further understand that the Dealer and or the financial institution(s) that evaluate my/our application may require additional information.

Your e-mail Address:

How did you hear about us?

I/We understand and have read the dealers Privacy Policy.

I wish to

Signature(s) (Place your Initals in box)

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