Dealership
LAKE VIEW FORD INC. |
Insurance Co.
|
Agent's Name
|
Telephone No.
|
Approved By
|
Approved No.
|
A
P
P
L
I
C
A
N
T
|
First
Middle
Last
|
Social Security No.
|
No. Dep's
Incl. Self
|
Birthdate
| |
| | |
Age
|
Address (No. St.) Need
Min. 3 Yrs
|
City and State
|
Zip Code
|
How Long
|
Mrd
Unmrd.
Sex
(M)
(U)
(S)
ANSWERED SECURED LOAN
ONLY |
[ ]Own
[ ]Rent
[ ]Other
[ ]Parents
[ ]Land Contract |
Purchase Price
$ |
Balance Owed
$ |
Mthly. Instal.
$ |
Mt. Hldr/Land Contract
Hldr, Landlord
|
Market Value
|
Previous Address (No.St.)
Need Min. 3 Yrs
|
City and State
|
Zip Code
|
How Long
|
Home Tele No.
|
|
* NOTICE - BEFORE ASKING,
APPLICANT MUST BE TOLD ONE NEED NOT REVEAL ALIMONY, CHILD SUPPORT OR SEPARATE
MAINTENANCE INCOME IF ONE DOES NOT CHOOSE TO HAVE SUCH CONSIDERED IN THE
BASIS FOR CREDIT.
|
Employer - Need Min. 3 Yrs.
|
Occupation
|
Office Tele. No.
|
Gross Monthly Pay
|
How Long
|
Previous Employer
|
Occupation
|
Office Tele. No.
|
Gross Monthly Pay
|
How Long
|
| Other Income Monthly
$ |
Source of Other Income
|
Bank Reference
( )CKG
( )SVG
|
Education:
[ ] High School
[ ]College Degree _____________________ |
NEAREST
RELATIVE
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Name
Address
Phone
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