Secure Loan Application

Primary Borrower Information

Loan Information

Desired Loan Amount:

Desired Monthly Payment:

Personal

First Name:

Middle Initial:

Last Name:

Address:

City:

State:

Zip:

Home Phone:

Cell Phone:

Fax:

- -

Email:

Social Security Number:

- -

Birthday:

/ /

Landlord or Mortgage Company Name:

Mortgage or Rent:

per month

Time at Residence:

Years

Landlord or Mortgage Company Address:

Phone Number:

Time at Residence:

Months

Residence Type:

If you have lived at your current residence less than 5 years, please enter your prior address,city,state,zip:

Previous Address:

How long did you live there?:

Married, Separated, Unmarried:

Which accounts are in your name:

Utilities Savings Checking Phone

Drivers Lic. #:

Drivers Lic. State:

(CA,NY, etc.)

Driver Lic. Exp. Date:

(MM/DD/YYYY)

# of Dependents:

Employment

Employer Name:

Employer Address:

Employer City:

Employer State:

Employer Zip:

Employment Phone:

Employment Status:

Occupation:

Time On Job:

Years

Time On Job:

Months

How often are you paid:

Gross Monthly Income:

Source of Income:

(i.e. W2, 1099, Retired, SSI, Permanent Disability, Student Income).

Other Income:

per month

Source of other income:

Child Support, 2nd Job, Alimony, Etc

Have you filed for bankruptcy in the last 5 years?

Yes No

If so, enter date filed and discharge date:

Consent:

I agree that by submitting this application, I authorize and give this dealership, as well as any potential financing source this dealership presents this application to, my consent to obtain my credit report from any credit reporting agency used to complete an investigation of my credit.

Do you have an open auto loan?:

Do you have an open auto loan?

Yes No

Lender Info:

Balance:

Monthly Payment:

Vehicle Applying For

Vehicle Make:

Vehicle Model:

Vehicle Year:

Exterior Color:

Stock Number:

Down Payment

Down Payment Amount:

Desired Monthly Payment:

Trade-In Details

Trade-in Make:

Trade-in Model:

Trade-in Year:

Trade-in Mileage:

Vin #:

Found on Driver's Door Jam or Driver's Side corner of the windshield

Condition of Trade:

Co-borrower Information

Personal

First Name:

Middle Initial:

Last Name:

Address:

City:

State:

Zip:

Home Phone:

Cell Phone:

Fax:

- -

Email:

Social Security Number:

- -

Birthday:

/ /

Landlord or Mortgage Company Name:

Mortgage or Rent:

per month

Time at Residence:

Years

Landlord or Mortgage Company Address:

Phone Number:

Time at Residence:

Months

Residence Type:

If you have lived at your current residence less than 5 years, please enter your prior address,city,state,zip:

Previous Address:

How long did you live there?:

Married, Separated, Unmarried:

Which accounts are in your name:

Utilities Savings Checking Phone

Drivers Lic. #:

Drivers Lic. State:

(CA,NY, etc.)

Driver Lic. Exp. Date:

(MM/DD/YYYY)

# of Dependents:

Employment

Employer Name:

Employer Address:

Employer City:

Employer State:

Employer Zip:

Employment Phone:

Employment Status:

Occupation:

Time On Job:

Years

Time On Job:

Months

How often are you paid:

Gross Monthly Income:

Source of Income:

(i.e. W2, 1099, Retired, SSI, Permanent Disability, Student Income).

Other Income:

per month

Source of other income:

Child Support, 2nd Job, Alimony, Etc

Have you filed for bankruptcy in the last 5 years?

Yes No

If so, enter date filed and discharge date:

Consent:

Do you have an open auto loan?:

Do you have an open auto loan?

Yes No

Lender Info:

Balance:

Monthly Payment:

Vehicle Applying For

Vehicle Make:

Vehicle Model:

Vehicle Year:

Exterior Color:

Stock Number:

Down Payment

Down Payment Amount:

Desired Monthly Payment:

By submitting this application, I certify that all information herein is true and complete. I agree I am providing this information to the dealer identified in this application and acknowledge that my information may be shared pursuant to the dealer’s privacy policy, if applicable. I hereby authorize this dealer, and any financial institution engaged as a service provider by this dealer, to retain this application and to check and verify my credit, employment and salary history. By submitting this application, I acknowledge I am authorizing this dealer to check my credit.

Cool Rides of Colorado SpringsSecure Loan Application

Primary Borrower Information

Loan Information

Personal

Employment

Do you have an open auto loan?:

Vehicle Applying For

Down Payment

Trade-In Details

Co-borrower Information

Personal

Employment

Do you have an open auto loan?:

Vehicle Applying For

Down Payment

Cool Rides of Colorado Springs
Secure Loan Application