Applicant Information

First Name*

Last Name*

Email Address*

Phone #*

Date of Birth*

Social Security #*

Current Address*

Address line 2

City*

State*

Zip Code*

Residence Type*

Time at Residence - Year/Months*

If less than 2 years, please fill out below

Monthly Rent/Mortgage*

Previous Address (If Less than 2 Years at Current Address)

Address line 2

City

State

Zip Code

Employment info

Employer Name*

Job Title*

Time of Employment - Year/Months*

If less than 2 years, please fill out below

Employer Phone #

Gross Monthly Income*

Additional Income (Monthly Amount & Source)

Previous Employer Name (If Less than 2 Years at Current Employer)

Employer Phone #

Time of Employment - Year/Months

Tell us about the vehicle you want

Year

Make

Model

Trim

Total Loan Amount*

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I agree to give permission for the above applicant(s) Consumer Credit Report(s) to be obtained, at no cost to me, in order to help determine the types and extent of financing which are available*

In connection with your transaction, Automotive Imports may acquire information about you as described in this notice, which we handle as stated in this notice.

We may collect personally identifiable information such as name, postal address, telephone number, e-mail address, social security number, date of birth, etc. This personal information is collected and used by Automotive Imports Credit Application staff for the purpose of facilitating a relationship or business transaction.

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