Apply For Financing

APPLICANT INFORMATION

First Name

Last

Cell Phone

E-mail

Birth Date (MM/DD/YYYY)

Marital Status

Social Security Number

Home Address

City, State, Zip

How long have you lived here?

Do you own or rent your home?

Own

Rent

Payment or rent amount (Monthly)

Landlord name or mortgage holder name

Landlord or mortgage holder phone

Are you under lease?

Yes

No

If so, what is the length of your lease?

If you have lived in your current residence for less than 3 years please give us your previous address.

City, State, Zip

How long did you live here?

Employer Information

Present Employer

Job Title / Position

Address

City, State, Zip

Monthly gross (Before taxes)

Phone

How long have you worked there?

Please provide your previous employer if you have worked at your current job for less than 3 years.

Address

City, State, Zip

Phone

How long did you work there?

Spouse/Partner Employment Info

Spouse/Partner name

Spouse/Partner present employer

Spouse/Partner monthly gross

ASSET & DEBT INFORMATION

Vehicle Information

Present vehicle financed

Financed through who?

Monthly payment

Credit Card(s)

Credit card company #1

Max limit

Current balance

Credit card company #2

Max limit

Current balance

Additional Information

Do you have any dependants

Yes

No

If so, what are their ages?

Do you receive child support?

Yes

No

If you receive child support please tell us how much.

Do you pay child support?

Yes

No

If you pay child support please tell us how much.

Credit score (roughly)

Have you had any property repossessed ?

Yes

No

If yes, what and when?

Do you have any lawsuits pending against you ?

Yes

No

Are you contemplating filing bankruptcy?

Yes

No

Have you consulted with a bankruptcy attorney in the last six months?

Yes

No

Average total monthly utility bills that you pay

Max down payment you can do

Max monthly payment you can afford

Do you have a trade in?

Yes

No

If yes, please enter Year/Make/Model/Mileage:

What vehicle are you interested in ?

Additional Information / Additional Income

Who from Value-Ride did you talk to? Whether it be on the phone, Facebook or email please provide their name so they may continue to assist you in getting a vehicle

How did you hear about us?

FAIR CREDIT REPORTING ACT DISCLOSURE: This application for credit may be submitted by the dealer to various financial institutions in connection with possible purchase or authorization of a vehicle contract. Upon request, names of other institutions receiving this application will be provided. The undersigned jointly and severally (1) certify the above information to be accurate and complete and intend it to be relied upon to judge creditworthiness; (2) agree that this application and all related information may be indefinitely retained whether or not credit is extended; (3) certify that the vehicle will not be used for any illegal or restricted purpose; (4) authorize consumer credit reports and investigation of asset, debt, and employment history to be obtained in connection with this application and for any update, review, collection, renewal or extension of the credit received; (5) authorize the exchange of credit, account and financial information about the undersigned, AND UNLESS THE CIRCLE THAT FOLLOWS IS MARKED, AUTHORIZE THE DEALER AND ASSIGNEEE OR OTHER PERSON TO WHOM THIS APPLICATION IS SUBMITTED TO SHARE AND USE INFORMATION ABOUT ME, INCLUDING INFORMATION IN MY APPLICATION, WITH OTHER ENTITIES THAT ARE RELATED TO THEM BY COMMON OWNERSHIP OR AFFILIATED BY THEM BY COMMON CONTROL. IF THE CIRCLE IS MARKED, I DIRECT THE DEALER AND ANY ASSIGNEE OR OTHER PERSON TO WHOM THIS APPLICATION IS SUBMITTED NOT TO GIVE INFORMATION TO SUCH ENTITIES (OTHER THAN INFORMATION ON THEIR OWN TRANSACTIONS AND EXPERIENCES) ¢; (6) agree to be solely responsible for making arrangements for delivery of communications to be provided to the undersigned in connection with this application; and (7) I ALSO ACKNOLEDGE RECEIPT OF A COPY OF THIS APPLICATION. Everything that I have stated in this application is correct to the best of my knowledge. You are authorized to check my credit and employment history and to answer questions about your credit experience with me. You are authorized to contact my landlord or mortgage holder and references for verification. ACKNOWLEDGMENT AND CONSENT