ATTENTION:
 Please be sure to fill out the information completely and accurately before submitting your application. Also, double-check the information you've entered before clicking the "SUBMIT" button.
APPLICANT:
 
Name:
 		 Address:
 		 Email Address:
 
City:
 		 State:
 		 Zip Code:
 
Work Phone:
 		 Home Phone:
 		 Date of Birth:
mm/dd/yyyy
Marital Status:
 		 Soc. Sec Number:
 		 Monthly Gross Income:
 
Time at Current Job:

 		 Time at Current Residence:

 		 Living Arrangements: 

 
Have You Ever Filed for Bankruptcy?
 		 Have You Ever had a Repossession?

 		 Down Payment: 

 
SPOUSE/CO-APPLICANT:
 
First Name:
 		 Middle Name: Last Name:
Date of Birth:
mm/dd/yyyy		 Soc. Security #:
 		 Monthly Gross Income:
 
Time at Current Job:

 		 Have You Ever Filed for Bankruptcy?
 		 Have You Ever had a Repossession?  
 
AUTO INQUIRY INFO:
 
Stock Number:
 		 Location:
 		 Trade In?:
 
Approx. Trade Value:   
 		 Amount Owed Against Trade:     

By submitting this credit application, I/we certify that the information provided on this application is, to the best of my/our knowledge, complete and accurate. I/we understand that Barrett Motors, Inc. will rely on this information to judge my/our credit worthiness, and will retain this application and information about me/us whether or not this application is approved. Further, I/we authorize an investigation of my/our credit, employment and residency history, in connection with which my/our credit report(s) may be obtained from one or more consumer reporting agencies. I/we further understand that Barrett Motors, Inc. may require additional information.