Se Habla Espanol

Financee Su Proximo Vehiculo

Aplicacion de Credito En Linea
(In English)

Section A: Applicant Information
(Required Information Highlighted in GOLD)
Nombre (Primer, Apellido):
(requerido)
Dirección Actual:
(requerido)
Ciudad:
 (requerido)
Estado:
 (requerido)
Código Postal:
 (requerido)
Número de Teléfono:
(requerido)
E-Mail Address:
(requerido)
Tiempo en Residencia Actual:
 Years: Months:
Pago Mensual:
 $ per month
Fecha de Nacimiento:
 (requerido)
Numero de Seguro Social:
 (requerido)
Numero de Licencia
 (requerido)
Estado:
(requerido)
Expiration Date:
 (requerido)

Employment Information
(Required Information Highlighted in GOLD)
Compañia Actual:
Dirección Actual:
Ciudad:
Estado:
Código Postal:
Teléfona de Trabajo Actual
Occupacion:
Tiempo en presente Trabajo:
 Years: Months:
Cuanto Gana?

Other Income - Source(s) of other income: alimony, child support or separate maintenance income need not be disclosed if you do not wish to have it considered as a basis for repaying this obligation.
Additional Monthly Income:
$
Sources:

By signing this application:
1.
 We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.
2.
 I authorize Dealer, TIM STEWART FORD AND ANY FINANCE COMPANY, bank, or other financial institution to which the Dealer submits my application ("you or your") to investigate my credit and employment history, obtain credit reports, and release information about your credit experience with me as the law permits.
3.
 If an account is created, I authorize you to obtain credit reports for the purpose of reviewing or taking collection action on the account, or for other legitimate purposes associated with the account.
4.
 I certify that I have read and agree to the terms of this application and that the information in it is complete and true.
5.
 I authorize you to start a credit investigation based on the information voluntarily provided by me which is true and correct, and release all my current debts. In addition, I authorize you to obtain federal and state records of employment and income history, including State Employment Security Agency ("SESA") records. This SESA authorization is for this transaction only and continues in effect for one (1) year unless limited by state law, in which case the authorization continues in effect for the maximum period, not to exceed one (1) year, as allowed by law. A bankruptcy proceeding is not in progress nor expected. If the attached application is submitted in the name of a business, a current and year-end financial statement, including P&L statement, and balance sheet may be required, audited if possible.

Please sign and date your application:
Signature (your initials):
Today's Date: