Credit Application

Last Name Address SSN Time At Residence Previous Address Previous Address Employer W2____ 1099____ Mo Income $ Other Income $/Mo Previous Employer Previous Employer Bank Name Co-Borrower Last Name Address SSN Time At Residence Previous Address Previous Address Employer W2____ 1099____ Mo Income $ Other Income $/Mo Previous Employer Previous Employer Bank Name Position $/Hr Address PT FT Temp Hours worked per week: Regular _____ OT _____ DL# Landlord Name First Name City ST MI ST DOB Phone ZIP Rent/Mtg $ Phone How Long: How Long: Phone How Long Hire Date Phone Address Address Phone Phone Checking__Saving__Both__ Position $/Hr Address PT FT Temp Hours worked per week: Regular _____ OT _____ DL# Landlord Name First Name City ST MI ST DOB Phone ZIP Rent/Mtg $ Phone How Long: How Long: Phone How Long Hire Date Phone Address Address Phone Phone Checking__Saving__Both__

Source of Income

Source of Income

I/We certify that the above information is true and complete to the best of my/our knowledge. I/We certify that I/we have attained the age of majority. I/We authorize The Used Car Warehouse to check my/our credit and employment history, and to provide, review, and/or obtain information about credit experiences with me/us.

APPLICANT SIGNATURE____________________________________________________ DATE_________________________

APPLICANT SIGNATURE____________________________________________________ DATE_________________________

Please check box A if the credit is in Borrower's Name only or box B if the credit is in Co-Borrower's/Other person's name only.

C. CREDIT
CHECK

Co-maker Account:
TYPE COMPANY/PAYEE CITY

Primary Borrower:
ACCOUNT NO. BALANCE MO. PAYMENTS

A

B

BE SURE TO LIST ALL OPEN ACCOUNTS WITH OR WITHOUT A BALANCE. ATTACH SEPARATE SHEET IF NECESSARY.

TOTAL OBLIGATION MARKET VALUE

LOAN WILL BE REJECTED IF ALL DEBT INFORMATION IS NOT LISTED.

D. ASSETS
A B
TYPE ACCOUNT TYPE DESCRIPTION (LIST ALL OTHER ASSETS INCLUDING AUTOS, REAL ESTATE, ETC.)

A. BORROWER
TYPE
CHECKING COMPANY NAME LOCATION ACCOUNT NO. APPROX. BAL

B. CO-BORROWER/NON-APPLICANT/CO-MAKER
TYPE
CHECKING COMPANY NAME LOCATION ACCOUNT NO. APPROX. BAL

DEPOSIT ACCOUNTS, INCLUDE CHECKING/SAVINGS AT BANK, CREDIT UNIONS AND SAVINGS & LOAN ASSOCIATIONS

SAVINGS

SAVINGS

A. PERSONAL REFERENCES
NEAREST RELATIVE NAME (NOT LIVING WITH YOU PHONE NO.

B. PERSONAL REFERENCES
NEAREST RELATIVE NAME (NOT LIVING WITH YOU PHONE NO.

RELATIVE ADDRESS (STREET, CITY, STATE, ZIP)

RELATIONSHIP PHONE NO.

RELATIVE ADDRESS (STREET, CITY, STATE, ZIP)

RELATIONSHIP

PERSONAL REFERENCE (NOT RELATED)

PERSONAL REFERENCE (NOT RELATED)

PHONE NO.

PERSONAL REFERENCE ADDRESS (STREET, CITY, STATE, ZIP)

PERSONAL REFERENCE ADDRESS (STREET, CITY, STATE, ZIP

A. & B. GENERAL QUESTIONS
IF A "YES" ANSWER IS GIVEN TO A QUESTION, PLEASE EXPLAIN ON AN ATTACHED SHEET BORROWER YES NO COBORROWER YES NO IF A "YES" ANSWER IS GIVEN TO A QUESTION, PLEASE EXPLAIN ON AN ATTACHED SHEET BORROWER YES NO COBORROWER YES NO

HAVE YOU EVER FILED A PETITION FOR CHAPTER 13? HAVE YOU FILED FOR BANKRUPTCY WITHIN THE LAST 0 YEARS? ARE ANY SUITS PENDING, JUDGMENTS UNSATISFIED, ALIMONY OR MAINTENANCE AWARDS AGAINST YOU? HAVE YOU EVER APPLIED FOR CREDIT USING ANOTHER NAME? LIST OTHER NAMES

HAVE YOU EVER HAD ANY AUTO, FURNITURE OR OTHER PROPERTY REPOSSESSED? DO YOU HAVE ANY PAST DUE BILLS? ARE YOU A COMAKER, ENDORSER, OR GUARANTOR ON ANY LOAN OR NOTE? IF YES, LIST NAME AND AMOUNT IF YES, LIST NAME AND AMOUNT

Graham-Leach-Bliley Privacy Notice
Your privacy rights are important to us. Please read this notice carefully to help us protect your privacy. You are hereby notified that this organization in connection with your transaction(s), may obtain information about you as described in this notice. We will handle this information privately, but in order to process your transaction(s) this information may be disclosed to third parties as provided by law. 1. We collect non-public personal information about you from the following sources: a. Information we receive from you on credit, insurance or other type applications, from our website and other forms, such as (but not limited to) your name, address, social security number, assets and income; b. Information about your transaction(s) with us, our affiliates, or others such as your account balance, payment history, banking accounts, credit record; and c. Information about you we may receive from credit reporting agencies, credit references and employers. 2. We may disclose all of the information we collect, as described above, to companies and others that perform marketing services on our behalf or to other financial institutions with whom we have joint marketing agreements. We may make such disclosures about you as a consumer, a customer, or as a former customer. 3. We may also disclose non-public personal information about you as a consumer, customer, or as a former customer to non-affiliated third parties as permitted by law. We may disclose non-public personal information about our customers to the manufacturer of the vehicle so that they may use that information to better serve you. 4. At this organization we restrict access to non-public personal information about you only to those employees, agents and subcontractors who need to know that information in order to provide products or services to you. In accord with this policy, we maintain physical, electronic and other procedural safeguards that comply with federal regulations to guard your non-public personal information inside our organization and protect its confidentiality. 5. Your right to “opt-out” of disclosure: If you prefer that we not disclose non-public personal information about you to the manufacturer you may direct us not to make these disclosures. You should be aware that if you do not wish this non-public personal information disclosed it may affect our ability to process this transaction(s) for you. If you wish to do this, please initial the block below:

Please do not disclose any non-public personal information about me to the vehicle manufacturer.
(No initials indicates your decision not to opt out of disclosure of non-public personal information to the vehicle manufacturer. Initials

CUSTOMER(S) ACKNOWLEDGMENT:
I (we) acknowledge that I (we) received a copy of this notice on the date indicated below:

Customer’s Signature

Customer’s Name Printed
-

Date

Customer’s Signature

Customer’s Name Printed
-

Date

OPT-OUT OPTION You may limit disclosures of the personal information we obtain.
If you prefer that we not disclose non-public personal information about you to non-affiliated third parties, you may “opt-out and direct us not to make those disclosures. Please note that we still may disclose non-public information to affiliated third parties, as permitted by law. Note: (To opt back in, notify us in writing at the address shown below.) You may “opt-out” at any time by: Contacting us at: or by: Filling out this form and signing it below, and returning it in person, or by mail to:

YES, I would like to “opt-out” and have no disclosures made about my non-public personal information.

Customer’s Signature

Customer’s Name Printed
-

Date

Please be aware, that should you “opt-out”, we will be prohibited from disclosing your credit record and other references to consumer credit agencies, financial service providers, and other automobile or vehicle brokers. This may limit our ability to help you arrange financing, or other services needed to complete this transaction, or future transactions.

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