Secure Loan Application

Hollatz Auto Sales
Secure Loan Application

Primary Borrower Information

Personal

First Name:

Middle Initial:

Last Name:

Birthday:

/ /

Age:

Current Address(Number & Street):

City:

State:

Zip:

Applicants Home Number:

Cell Number:

Amount:

Mortgage $

Amount:

Rent $

Time at present Address?:

Drivers Lic. #:

Email:

Social Security Number:

- -

Previous Address if Less Than Two Years at Present (Street,City,State & Zip Code):

Length at Address:

Employment

Current Employer:

Employer Address:

Email Address:

Present Occupation:

Time On Job:

Years

Time On Job:

Months

Business Phone:

Gross Pay Amount:

Monthly$

Other Income:

per month

Other Source of Income:

Other Source Of Income:

(When you get Paid)

Previous Employment (If current is less than 5 years)

Previous Employer Name:

Previous Employer City:

Previous Employer State:

Previous Employer Zip:

Length of Previous Job:

Years Months

Financial Information

Bank Name:

Address of Bank (Street,City,State & Zip):

Checking:

Savings:

Direct Deposit:

Landlord Name

Landlord Address (Street, City,State & Zip):

Landlord Telephone Number:

Signature

Signature:

Type your initials

Date:

/ /

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.

Hollatz Auto Sales
Secure Loan Application

Primary Borrower Information

Loan Information

Personal

Employment

Previous Employment (If current is less than 5 years)

Financial Information

Signature

Co-borrower Information

Hollatz Auto SalesSecure Loan Application

Primary Borrower Information

Loan Information

Personal

Employment

Previous Employment (If current is less than 5 years)

Financial Information

Signature

Co-borrower Information

Hollatz Auto Sales
Secure Loan Application