Secure Loan Application

Primary Borrower Information

Loan Information

Salesperson:

How did you hear about us?:

Desired Monthly Payment:

Desired Loan Amount:

Personal

First Name:

Middle Initial:

Last Name:

Address:

City:

State:

Zip:

Daytime Phone:

Evening Phone:

Email:

Social Security Number:

- -

Birthday:

/ /

Mortgage/Rent Payment:

per month

Residence Type:

Time at Residence:

Years

Time at Residence:

Months

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

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)

Employment

Employer Name:

Employer Address:

Employer City:

Employer State:

Employer Zip:

Employers Email Address:

Business Phone:

Occupation:

Time On Job:

Years

Time On Job:

Months

Gross Monthly Salary:

(numbers only)

Consent:

I certify that the information in my application is complete and true. I authorize Road Master Auto Sales and various financial institutions, to investigate my credit and employment history, obtain credit reports, and release information about their credit experience with me as permitted by law. I also acknowledge receipt of a copy of this credit application, including the disclosures above

Vehicle Information

Vehicle Make:

Vehicle Model:

Vehicle Year:

Vehicle Mileage:

Down Payment

Down Payment Amount:

Trade-In Details

Trade-In Make:

Trade-In Model:

Trade-in Year:

Trade-in Mileage:

Additional Comments:

Co-borrower Information

Loan Information

Salesperson:

How did you hear about us?:

Desired Monthly Payment:

Desired Loan Amount:

Personal

First Name:

Middle Initial:

Last Name:

Address:

City:

State:

Zip:

Daytime Phone:

Evening Phone:

Email:

Social Security Number:

- -

Birthday:

/ /

Mortgage/Rent Payment:

per month

Residence Type:

Time at Residence:

Years

Time at Residence:

Months

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

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)

Employment

Employer Name:

Employer Address:

Employer City:

Employer State:

Employer Zip:

Employers Email Address:

Business Phone:

Occupation:

Time On Job:

Years

Time On Job:

Months

Gross Monthly Salary:

(numbers only)

Consent:

Vehicle Information

Vehicle Make:

Vehicle Model:

Vehicle Year:

Vehicle Mileage:

Down Payment

Down Payment Amount:

Trade-In Details

Trade-In Make:

Trade-In Model:

Trade-in Year:

Trade-in Mileage:

Additional Comments:

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.

Roadmaster Auto SalesSecure Loan Application

Primary Borrower Information

Loan Information

Personal

Employment

Vehicle Information

Down Payment

Trade-In Details

Co-borrower Information

Loan Information

Personal

Employment

Vehicle Information

Down Payment

Trade-In Details

Roadmaster Auto Sales
Secure Loan Application