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Secure Finance Application
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Statement of Consent

I certify that the information provided by me is correct. I also understand that you will be checking with credit reporting agencies. I authorize an investigation of my credit and employment history and the release of information about my credit experience.

Please initial below to indicate that you have received a copy of our Privacy Notice and agree to all of the above.

YOUR CREDIT APPLICATION IS GOING THROUGH A SECURE WEBSITE AND YOUR IDENTITY IS SAFE



(Initial here)*

 
 

Vehicle Information

Type*

 

Condition

 

Year*

 

Make*

 

Brand

 

Model

 

Down Payment

 

Your Contact Information

First Name*

 

Last Name*

 

Driver's License

 

Work Phone

 

Residence Phone*

 

E-mail*

 

Social Security Number*

 

Marital Status

 

Male/Female

 

Date of Birth*

 

Physical Address Information

Physical Address*

 

City*

 

State*

 

Zip*

 

County*

 

Housing Information

Do you Rent or Own your home, or other?*

 

LandLord / Mortgage Holder

 

Rent / Mortgage Monthly Amount*

 

Mortgage Balance

 

Time at Current Residence*

 

Banking Information

Name Of Bank

 

Account Types

 

Name Of Bank

 

Account Types

 

Previous Residence (If less than 5 years at Current Residence...)

Address

 

City

 

State, Zip

 

How long at Previous Residence

 

Employer Information

Occupation*

 

Employer Name*

 

Employer Address*

 

Employer City*

 

Employer State*

 

Employer Zip*

 

Employer Phone*

 

Salary (Annually Gross)*

 

Time at Employer*

 

Type of Employment

 

Other Income

 

Other Income Frequency

 

Additional Comments
Please include any information that you feel may help us process your application

 

Upload Signature

Applicant Signature

 

References

Name:

Phone:

City:

State:

Name:

Phone:

City:

State:

Name:

Phone:

City:

State:

Name:

Phone:

City:

State:
Privacy Notice In connection with your transaction, the dealership may obtain information about you as described in this notice.

1. We collect nonpublic personal information about you from the following sources: Information we receive from you on applications or other forms; Information about your transactions with us, our affiliates or others; and, Information we receive from consumer reporting agency (e.g., credit bureau).

2. We may disclose all of the information we collect, as described above, to companies that perform marketing services on our behalf or to financial institutions with whom we have joint marketing agreements. We may make such disclosures about you as a consumer, customer, or former customer.

3. We may also disclose nonpublic personal information about you as a customer, customer for former customer to non-affiliated third parties as permitted by law.

4. We restrict access to nonpublic personal information about you to those dealership personnel who need to know that information in order to determine your eligibility for products and services, and to provide you with products and services, and to those who are subject to confidentiality provisions and restrictions that prohibit use of information beyond the performance of specified services. To guard your nonpublic personal information we maintain physical, electronic, and procedural safeguards that comply with federal standards.

By submitting this application, you represent that all information in the form is accurate and complete to the best of your knowledge. You are also confirming that you are competent to enter into contracts and that no bankruptcy proceedings are in progress or anticipated which involve you. Please note that credit is granted based on scores, payment history, assets, etc. and the decision is that of the bank, not us. We may retain this application whether or not credit is granted. You agree to pay all fees in connection with your loan. You authorize us to obtain information from others concerning your credit standing and other relevant information impacting on this application. Your electronic signature confirms you understand our policies, terms and conditions and grants us permission to commence your loan.

I understand your policies, terms and conditions. (required) Submit Electronic Signature.