Personal Information    Social security number: (e.g., 555-55-5555)    Date of Birth: * First Name:    Middle Initial: * Last Name: * Address: * City: * State: * Zip: * E-mail:    Home phone (e.g., 203-555-5555):    Age: 18 or over Under 18    Do you have a valid driver's license? Yes No    What is your residential situation? Rent Own Live with family/friends    How long have you lived at your current residence? Less than six months Six months to one year One to three years More than three years    How long did you live at your last residence? Less than six months Six months to one year One to three years More than three years    What is your bankruptcy history? Never filed 1 year ago 1 to 3 years ago 3+ years ago    Any repossessions? None Less than six months Six months to one year One to three years More than three years Work Information Employer: Work phone: Position held: What is your current MONTHLY income? (e.g., $2000): How long have you been working at your current job? Less than six months Six months to one year One to three years More than three years How long were you working at the job before your current one? Less than six months Six months to one year One to three years More than three years Other Information Best time to call you? Morning Afternoon Evenings May we check your credit report with a national credit bureau? Permission granted Permission NOT granted What kind of vehicle are you interested in? (year make model) Do you have a trade-in vehicle? Yes No What down payment do you expect to make? Less than $500 $500 to $1000 More than $1000 What monthly payment range are you looking for? Less than $200 per month $200 - $300 per month $300 - $400 per month   For the purpose of securing credit from you, I certify that the above information is true and complete to the best of my knowledge. I further certify that I have attained the age of majority. I authorize you to check my credit and employment history and to provide and/or obtain information about credit experiences with me. I have read the above statement and accept the terms Yes No * These fields are required Joomla Professional Work