Secure Loan Application

Primary Borrower Information

Loan Information

Appx Credit Score:

(answer required)

Desired Monthly Payment:

Personal

First Name:

Middle Initial:

Last Name:

Address:

City:

State:

Zip:

Daytime Phone:

Evening Phone:

County for Sales Tax Rate:

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.)

Is your drivers license valid?

Employment

Employer Name:

Employer Address:

Employer City:

Employer State:

Employer Zip:

Business Phone:

Occupation:

Employment Status:

Time On Job:

Years

Time On Job:

Months

How often are you paid:

Gross Monthly Income:

Other Income:

Alimony, child support, or separate maintenance income do not need to be revealed if you do not wish to have if considered as a basis for repaying this obligation.

Type of Other Income:

Consent:

I/we certify that the above information is complete and accurate. You, the Seller, are authorized to investigate my credit and employment history, including obtaining my credit report from any credit reporting agency(s) of your choice. My/our authorization extends to affiliates of the Seller, including Assignees and or Credit Unions to whom the Seller may offer (or submit my credit application on my behalf) or, for purchase the installment credit contract being considered herein. I agree to the use of electronic applications on my behalf. I acknowledge that I agree to the statement & terms of this Credit Application.

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

Personal

First Name:

Middle Initial:

Last Name:

Address:

City:

State:

Zip:

Daytime Phone:

Evening Phone:

County for Sales Tax Rate:

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.)

Is your drivers license valid?

Employment

Employer Name:

Employer Address:

Employer City:

Employer State:

Employer Zip:

Business Phone:

Occupation:

Employment Status:

Time On Job:

Years

Time On Job:

Months

How often are you paid:

Gross Monthly Income:

Other Income:

Alimony, child support, or separate maintenance income do not need to be revealed if you do not wish to have if considered as a basis for repaying this obligation.

Type of Other Income:

Consent:

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.

GOLDEN RULE AUTOSecure Loan Application

Primary Borrower Information

Loan Information

Personal

Employment

Vehicle Information

Down Payment

Trade-In Details

Co-borrower Information

Personal

Employment

GOLDEN RULE AUTO
Secure Loan Application