Secure Loan Application

Simply Auto Sales
Secure Loan Application

Primary Borrower Information

Personal

First Name:

Middle Initial:

Last Name:

Current Street Address:

City:

State:

Zip:

Time at Residence:

Years

Time at Residence:

Months

Email:

Home Phone:

Cell Phone:

Social Security Number:

- -

Birthday:

/ /

Residence Owned By:

Mortgage/Rent Payment:

per month

Drivers Lic. #:

Drivers Lic. State:

(CA,NY, etc.)

Employment

Employer:

Employee Start Date:

/ /

Job Title:

Work Phone:

Employee Gets:

Monthly Income:

per month

Bank Information

Bank Name:

Checking Account?:

Yes No

Savings Account:

Yes No

Down Payment

Desired Down Payment:

Vehicle Information

Vehicle your are interested in:

Consent

Consent:

I agree to accept your Privacy Notice electronically, and further acknowledge that I have read and/or to the Privacy Policy

Consent :

I agree, by checking this box , you certify that all of the statements in this application are true and complete and are made for the purpose of obtaining auto loan credit. You agree to provide and / or authorize Simple Auto Sales, and / or other lenders , to obtain such additional information as may be required, including credit reports , in order to complete the processing of your auto loan application and agree to the following : Additional Permissions.

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.

Simply Auto SalesSecure Loan Application