DEALER NAME AND NUMBER: Lease Retail
STANDARD CREDIT APPLICATION
Before completing this form please read the directions carefully. (Check appropriate box). Applicant, if married, may apply for a separate account.
• If you are applying for individual credit in your own name and relying on your own income or assets and not the income or assets of another person
as a basis for the repayment of the credit requested, complete only Section A.
• If you are applying for joint credit with another person, sign where indicated and complete Sections A and B.
• If you are married and live in a community property state, please complete Section A about yourself and Section B about your spouse. You must
sign this application. Your spouse must sign this application only if he/she wishes to be a co-applicant.
• If you are applying for business credit complete Section A. If you are applying for business credit with a co-applicant, complete Sections A and B.
FIRST NAME OR BUSINESS NAME MIDDLE LAST SR SOCIAL SECURITY NO. OR (TAX ID #) DATE OF BIRTH PHONE
MO. DAY YR.
JR ( )
E-MAIL ADDRESS
PRESENT NUMBER AND STREET CITY COUNTY STATE ZIP LIVED THERE
ADDRESS YEARS MONTHS
RENT BY MO. LANDLORD OR MORTGAGE HOLDER NAME MO. PAYMENT OR RENT $
CREDIT INFORMATION
LIVE WITH RELATIVES
OWN
APPLICANT’S
PREVIOUS HOME ADDRESS NUMBER AND STREET CITY COUNTY STATE ZIP LIVED THERE
(IF LESS THAN 2 YEARS AT YEARS MONTHS
PRESENT ADDRESS)
–A–
EMPLOYED BY NAME BUSINESS ADDRESS, NUMBER AND STREET CITY STATE HOW LONG BUS. PHONE NO.
SELF YEARS MONTHS
( )
OTHERS
TRADE OR OCCUPATION GROSS SALARY OR WAGES WK NAME OF PREVIOUS EMPLOYER ADDRESS NO. YEARS
MO
$ YR
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
TYPE OF OTHER INCOME SOURCE GROSS WEEK
AMOUNT MONTH
$ YEAR
NAME OF CREDITOR OF PHONE NO. ACCOUNT NO.
LAST CAR FINANCED
NAME AND ADDRESS OF PARENTS NAME ADDRESS PHONE NO. RELATIONSHIP
OR NEAREST RELATIVE
NOT LIVING WITH ME
RELATIONSHIP TO APPLICANT (IF ANY)
FIRST NAME MIDDLE LAST SR SOCIAL SECURITY NO. DATE OF BIRTH PHONE
MO. DAY YR.
( )
JR
E-MAIL ADDRESS
CREDIT INFORMATION
THE OTHER PARTY’S
PRESENT NUMBER AND STREET CITY COUNTY STATE ZIP LIVED THERE
ADDRESS YEARS MONTHS
RENT BY MO. LANDLORD OR MORTGAGE HOLDER NAME MO. PAYMENT OR RENT $
–B–
LIVE WITH RELATIVES
OWN
PREVIOUS HOME ADDRESS NUMBER AND STREET CITY COUNTY STATE ZIP LIVED THERE
(IF LESS THAN 2 YEARS AT YEARS MONTHS
PRESENT ADDRESS)
EMPLOYED BY NAME BUSINESS ADDRESS, NUMBER AND STREET CITY STATE HOW LONG BUS. PHONE NO.
SELF YEARS MONTHS
( )
OTHERS
TRADE OR OCCUPATION GROSS SALARY OR WAGES WK NAME OF PREVIOUS EMPLOYER ADDRESS NO. YEARS
MO
$ YR
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
TYPE OF OTHER INCOME SOURCE GROSS MONTHLY
AMOUNT
$
TO BE COMPLETED
NEW VEHICLE YEAR VEHICLE MAKE VEHICLE MODEL VEHICLE TRIM
INFORMATION
BY SELLER
USED
VEHICLE
CERTIFIED INVOICE/WHOLESALE/MSRP TERM MONTHLY PAYMENT ODOMETER MILEAGE
OTHER
CASH PRICE (1) NET TRADE (2) CASH DOWN AND/OR REBATES (3) UNPAID BALANCE (1 – 2 – 3) AMOUNT FINANCED
VEHICLE INSURANCE is required for the full term of the Contract, at your expense, against the hazards of fire, theft and accidental physical damage (including collision). This insurance must protect the interests of
you and the lender. The policies issued by the insurance company will describe the terms and conditions. YOU MAY CHOOSE THE PERSON THROUGH WHOM ANY INSURANCE IS OBTAINED.
I/we, the undersigned (1) make the above representations, which are certified correct, for the purpose of securing credit; (2) authorize financial institutions
to obtain consumer credit reports on me/us periodically and to gather employment history as they consider necessary and appropriate; (3) authorize
your affiliates to obtain credit reports on me/us; (4) authorize financial institutions, affiliates, and others to exchange credit, account and financial information
about me; (5) agree that if I/we gave you an e-mail address or cellular telephone number as a means of contacting me/us, you and any assignee to
whom you may assign my/our credit agreement are specifically authorized to use that information to contact me/us regarding any credit account that
you open for me/us; and (6) understand that the creditor or any financial institution to whom this application is submitted will retain this application whether
or not it is approved, and that it is my/our responsibility to notify the creditor of any changes of name, address or employment.
FAIR CREDIT REPORTING ACT DISCLOSURE: This application for credit may be submitted to various financial institution(s). Before this
application is submitted, the name(s) and address(es) of the institution(s) that will receive copies of this application will be disclosed to me/us.
CA, NY, OH, RI, VT AND WI RESIDENTS: SEE THE REVERSE SIDE OF THIS APPLICATION FOR FURTHER IMPORTANT DISCLOSURES AND
INFORMATION.
CO-APPLICANT’S SIGNATURE MEANS YOU INTEND TO APPLY FOR JOINT CREDIT
X X
APPLICANT’S SIGNATURE DATE CO-APPLICANT’S SIGNATURE: DATE
WOF 533 (11/07) C/S# 2011
CALIFORNIA RESIDENTS - AN APPLICANT, IF MARRIED, MAY APPLY FOR A SEPARATE ACCOUNT.
NEW YORK RESIDENTS - A CONSUMER REPORT MAY BE REQUESTED IN CONNECTION WITH THIS
APPLICATION. UPON REQUEST, YOU WILL BE INFORMED AS TO WHETHER OR
NOT A CONSUMER REPORT WAS REQUESTED, AND INFORMED OF THE NAME
AND ADDRESS OF THE CONSUMER REPORTING AGENCY THAT FURNISHED THE
REPORT. ON ANY UPDATE, RENEWAL OR EXTENSION OF THIS CREDIT,
SUBSEQUENT CONSUMER REPORTS MAY BE UTILIZED.
OHIO RESIDENTS - THE OHIO LAWS AGAINST DISCRIMINATION REQUIRE THAT ALL CREDITORS MAKE
CREDIT EQUALLY AVAILABLE TO ALL CREDIT WORTHY CUSTOMERS, AND THAT
CREDIT REPORTING AGENCIES MAINTAIN SEPARATE CREDIT HISTORIES ON
EACH INDIVIDUAL UPON REQUEST. THE OHIO CIVIL RIGHTS COMMISSION
ADMINISTERS COMPLIANCE WITH THIS LAW.
RHODE ISLAND RESIDENTS - A CREDIT REPORT MAY BE REQUESTED IN CONNECTION WITH THIS APPLICATION
FOR CREDIT. VEHICLE INSURANCE MAY BE OBTAINED FROM A PERSON OF
YOUR CHOICE.
VERMONT RESIDENTS - BY SIGNING THIS APPLICATION YOU CONSENT AND GIVE US PERMISSION TO
OBTAIN CREDIT REPORTS IN CONNECTION WITH ANY ACCOUNT ESTABLISHED
WITH US AS A RESULT OF THIS APPLICATION FOR CREDIT PURPOSES OF
REVIEWING THAT ACCOUNT, INCREASING THE CREDIT LINE ON THE ACCOUNT,
OR TAKING COLLECTION ACTION ON THE ACCOUNT.
MARRIED WISCONSIN RESIDENTS - WISCONSIN LAW PROVIDES THAT NO PROVISION OF ANY MARITAL PROPERTY
AGREEMENT, OR UNILATERAL STATEMENT OR COURT ORDER APPLIED TO
MARITAL PROPERTY WILL ADVERSELY AFFECT A CREDITOR'S INTERESTS
UNLESS, PRIOR TO THE TIME THAT THE CREDIT IS GRANTED, THE CREDITOR
IS FURNISHED WITH A COPY OF THE AGREEMENT, STATEMENT OR DECREE,
OR HAS ACTUAL KNOWLEDGE OF THE ADVERSE PROVISION.
