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Credit Application
First Name
Last Name
Address
City
State
Zip Code
Years at
Current Address
Date of Birth (mm/dd/yyyy)
Day Phone
Evening Phone
Mobile Phone
Social Security No.
E-mail
Confirm E-mail
Employed
YES
NO
Monthly HouseHold Income
(Gross/Pre Tax)
Employer Name
Employer Phone
Months at Current Employer
Bankruptcy
YES
NO
(Discharged in the past 12 months?)
Previous Installment Loan
YES
NO
Repossession
YES
NO
(In the past year)
Co-Signer Available?
YES
NO
Are you currently a homeowner?
YES
NO
Notes:
Please list the vehicle you are interested in. Include any additional comments or notes:
By submitting this application I hereby give Joe Romeo's United Chevrolet and / or it's lending partners, permission to pull my credit report. Your credit information may be shared with our partners for the sole purpose of obtaining vehicle financing per your request.
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