Secure Loan Application

EZ Auto Group LLC
Secure Loan Application

Primary Borrower Information

Loan Information

Desired Monthly Payment:

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:

Employment

Employer Name:

Employers Email Address:

Business Phone:

Occupation:

Time On Job:

Years

Time On Job:

Months

How much per paycheck:

(GROSS BEFORE TAXES)

How Do You Get Paid?

How Often do you Get Paid?:

If you have worked for your current employer less than 2 years, Please enter previous employer, occupation, and time on job:

Other Income:

per month

Source of other Income:

(if not applicable use N/A)

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.

Vehicle Information

Vehicle Make:

Vehicle Model:

Vehicle Year:

Down Payment

Down Payment Amount:

Comments

Additional Comments:

Co-borrower Information

Loan Information

Desired Monthly Payment:

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:

Employment

Employer Name:

Employers Email Address:

Business Phone:

Occupation:

Time On Job:

Years

Time On Job:

Months

How much per paycheck:

(GROSS BEFORE TAXES)

How Do You Get Paid?

How Often do you Get Paid?:

If you have worked for your current employer less than 2 years, Please enter previous employer, occupation, and time on job:

Other Income:

per month

Source of other Income:

(if not applicable use N/A)

Consent:

Vehicle Information

Vehicle Make:

Vehicle Model:

Vehicle Year:

Down Payment

Down Payment Amount:

Comments

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.

EZ Auto Group LLCSecure Loan Application

Primary Borrower Information

Loan Information

Personal

Employment

Vehicle Information

Down Payment

Comments

Co-borrower Information

Loan Information

Personal

Employment

Vehicle Information

Down Payment

Comments

EZ Auto Group LLC
Secure Loan Application