Rueschhoff Automobiles
Secure Loan Application

Primary Borrower Information

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Utilities
Savings
Checking
Phone
(CA,NY, etc.)
(MM/DD/YYYY)
per month
Years
Months
City: State: Zip:
Years Months
City: State: Zip:
Years Months
Years
Months
Gross (before deductions)
per month
Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for approval of this obligation
Years
Months

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.