Page 1

Phone (214) 398-8309 Fax (214) 391-7640

Auto City 129 S. Buckner Blvd

1234567890123456789012345678901212345678901234567890 1234567890123456789012345678901212345678901234567890 1234567890123456789012345678901212345678901234567890 Your Complete Honesty Is Important 1234567890123456789012345678901212345678901234567890 1234567890123456789012345678901212345678901234567890 1234567890123456789012345678901212345678901234567890

BUYER INFORMATION Legal Name:

Single Married Separated

Nickname:

Social Security Number:

Date of Birth

Drivers License #

Current Address:

Apt #

City:

Zip:

Permanent Address:

Apt#

City:

Zip:

Home Phone:(

)

Cell Phone:(

Name Telephone Listed In:

)

Email Address:

# of Children

RESIDENCY INFORMATION Buy

Rent

(Please Check One)

Lease/Mortgage is Listed in Whose Name:

Amount of Rent/Mortgage: $

Who Do You Pay Rent/Mortgage To:

Phone Number

Length of Time in Dallas County?:

Years

Mths:

Length of Time at Current Address?:

Previous Address:

Years:

From:

Months: To: How Long at This Job?

EMPLOYMENT INFORMATION Employed By:

Department

Employer’s Address:

City:

Phone Number (

)

Your Next Payday:

Years:

Mths:

Supervisor

Ext:

Shift or Hours

Take Home Amount: $

Weekly

Source of Additional Income

BiWeekly

Twice a Month

Monthly

Amount:

Alimony, child support or separate maintenance income need not be revealed if you do no wish to have it considered as a basis for repaying this obligation

Previous Employer Name:

Phone Number:

From

Single Married Separated

SPOUSE/ROOMMATE/COBUYER INFORMATION Legal Name:

To

Nickname:

Relationship To Buyer Social Security Number:

Date of Birth

Home Address: Home Phone:(

Drivers License # Apt #

)

Cell Phone:(

Employed By:

Zip: )

How Long at This Job?

Department:

Employer’s Address: Phone Number (

City:

City )

Your Next Payday:

Ext Take Home Amount: $

Source of Additional Income

Years:

Mths:

Supervisor Shift/Hours Weekly

Biweekly

Twice A Month

Monthly

Amount:

Alimony, child support or separate maintenance income need not be revealed if you do no wish to have it considered as a basis for repaying this obligation

I/We certify that the above information is true, accurate and complete. I/We also understand that providing false or misleading information will rescind all contracts made upon same. I/We authorize Auto City to gather whatever credit information it considers necessary to verify all information given on this credit application. I/We also authorize Auto City to give such information to others wishing to verify same.

Buyer’s Signature

Spouse/Roommate/Cobuyer Signature

We intend to apply for joint credit: Applicant

Co-Applicant

Date


1234567890123456789012345678901212345678901234567 1234567890123456789012345678901212345678901234567 1234567890123456789012345678901212345678901234567 1234567890123456789012345678901212345678901234567 Please do not write in shaded area 1234567890123456789012345678901212345678901234567 1234567890123456789012345678901212345678901234567 1234567890123456789012345678901212345678901234567

Applicants Name:

CURRRENT VEHICLE Year:

CREDIT INFORMATION Make:

Year Purchased:

Model:

How much do you owe on this car?

Financed By:

Phone #

1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 Open High Balance Payments Last Pay Next Due Pay History 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456

What Vehicle Did You Drive Here Today: If You did Not Drive here, Who Brought You?

Relationship?:

If You Were Referred, Whom May We Thank? 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 LEAD SOURCE AD SOURCE CRM 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 YES NO 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456

PLEASE LIST ALL PREVIOUS CAR CREDIT: Year

Make

Model

Who Financed The Car?

Year Purchased Was Vehicle Repossessed

Yes

No

If Repossessed, Please State When/Reason: Year

Make

Model

Who Financed The Car?

Year Purchased Was Vehicle Repossessed

Yes

No

If Repossessed, Please State When/Reason: Have You EVER Filed Bankruptcy:

Yes

No

Chap 7

Chap13 If Yes, When?

If Yes, Please Explain Circumstances:

Are You Contemplating Filing Bankruptcy?:

Yes

No 1234567890123456789012345678901212345678901234567890123456789012123

1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 MONTHLY INCOME 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 MONTHLY EXPENSES 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 Take Home Pay Applicant 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 Mortgage/Rent: Current Car Payment 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 Take Home Pay Co-applicant 1234567890123456789012345678901212345678901234567890123456789012123 Elect/Gas/Water: (Not Anticipated Payment) 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 Groceries: Gasoline 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 OTHER INCOME 1234567890123456789012345678901212345678901234567890123456789012123 Phone: 1234567890123456789012345678901212345678901234567890123456789012123 AFDC; 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 Insurance: List all Creditors&Payments 1234567890123456789012345678901212345678901234567890123456789012123 Social Security 1234567890123456789012345678901212345678901234567890123456789012123 Alimony/Child Support: Credit Cards: 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 Other 1234567890123456789012345678901212345678901234567890123456789012123 Child Care: Others: 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 Total Monthly Income: 1234567890123456789012345678901212345678901234567890123456789012123 Total Monthly Expenses: 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 INCOME AVAILABLE FOR CAR PAYMENT: PERCENTAGE OF INCOME: 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 VERIFIED BY: 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 APPROVED FOR: 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 Salesperson Stock # 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 Year Make Model 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 Price Cash Down 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 Mileage Repo Date Bought 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 Trade In Allowance ACV 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456 1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456

THIS AREA IS REQUIRED. PLEASE LIST ALL EXPENSES:


BUYER REFERENCES FATHER:

Here? Yes

Home Address Home Phone (

City )

MOTHER:

Home Phone (

Work Phone (

Home Address Home Phone (

Work Phone (

GRANDPARENT: Home Address Home Phone (

Here? Yes

Work Phone (

Home Phone (

Work Phone (

Home Phone (

Relationship Zip

No

State

Work Phone (

Zip

)

City )

Zip

No

Here? Yes

Home Address

Living? Yes

)

City

FRIEND:

Home Phone (

No

Here? Yes

)

Zip

State

Work Phone (

NEIGHBOR: Home Address

No

)

City )

Zip

State

Here? Yes

Home Address

No

)

Here? Yes

RELATIVE:

Living? Yes

State

City )

No

)

City )

Zip

State

BOY/GIRL FRIEND:

No

)

City )

Living? Yes

State

Here? Yes

Home Address

No

Work Phone (

CHILDREN: NAME:

SCHOOL/ADDRESS

NAME:

SCHOOL/ADDRESS

NAME:

SCHOOL/ADDRESS

State )

No Zip

No


CO-BUYER REFERENCES FATHER:

Here? Yes

Home Address Home Phone (

City )

MOTHER:

Home Phone (

Work Phone (

Home Address Home Phone (

Work Phone (

GRANDPARENT: Home Address Home Phone (

Here? Yes

Work Phone (

Home Phone (

Work Phone (

Home Phone (

Relationship Zip

No

State

Work Phone (

Zip

)

City )

Zip

No

Here? Yes

Home Address

Living? Yes

)

City

FRIEND:

Home Phone (

No

Here? Yes

)

Zip

State

Work Phone (

NEIGHBOR: Home Address

No

)

City )

Zip

State

Here? Yes

Home Address

No

)

Here? Yes

RELATIVE:

Living? Yes

State

City )

No

)

City )

Zip

State

BOY/GIRL FRIEND:

No

)

City )

Living? Yes

State

Here? Yes

Home Address

No

Work Phone (

CHILDREN: NAME:

SCHOOL/ADDRESS

NAME:

SCHOOL/ADDRESS

NAME:

SCHOOL/ADDRESS

State )

No Zip

No


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