Affordable Auto Rental & Sales
Secure Loan Application

Primary Borrower Information

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/ /
per month
Years
Months
Utilities
Savings
Checking
Phone
(CA,NY, etc.)
(MM/DD/YYYY)
Years
Months
(numbers only)
per month
Yes
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
This application is correct to the best of my knowledge. I understand that you will retain this application and any other credit information you receive whether or not a loan is approved. Affordable Auto and its assigns are authorized to check my credit and employment history and to answer questions about your credit experience with me. I authorize any person or consumer-reporting agency to complete and furnish to you any information it may have or obtain in response to your credit inquires whenever you make them. I hereby recognize the penalties and defenses resulting from giving a false statement of financial condition and that the giving of false information hereon may be illegal and fraudulent and may be the basis for denying a discharge in bankruptcy. I further state that I am not contemplating a bankruptcy action at the present time and that I have no unpaid judgements or executions or pending legal proceedings against me.

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.