APPLICANT:
Name:
Address:
Email Address:
City:
State:
Zip Code:
Work Phone:
Home Phone:
Date
of Birth:
mm/dd/yyyy
Marital Status:
SELECT ONE
SINGLE
MARRIED
Soc. Sec Number:
Monthly Gross Income:
----------------
$1,000 - $1,499
$1,500 - $2,499
$2,500 - $3,499
$3,500 - $4,999
$5,000+
Time at
Current Job:
----------------
Less than 6 months
6 Months - 1 Year
1-2 Years
2-3 Years
3-5 Years
5+ Years
Time at
Current Residence:
----------------
Less than 6 months
6 Months - 1 Year
1-2 Years
2-3 Years
3-5 Years
5+ Years
Living Arrangements:
---------------------
OWN
RENT
Have You Ever Filed for Bankruptcy?
---------------------
No
Yes, Within the Last Year
Yes, Within the Last Three Years
Yes, Within the Last Five Years
Yes, Over Five Years Ago
Have You Ever had a
Repossession?
---------------------
NEVER
1 -Five Years Ago or Longer
1 -Within the Last Four Years
2 -Within the Last Four Years
3 -Within the Last Four Years
Down Payment:
SPOUSE/CO-APPLICANT:
First Name:
Middle Name:
Last Name:
Date
of Birth:
mm/dd/yyyy
Soc. Security #:
Monthly
Gross Income:
----------------
$1,000 - $1,499
$1,500 - $2,499
$2,500 - $3,499
$3,500 - $4,999
$5,000+
Time at
Current Job:
----------------
Less than 6 months
6 Months - 1 Year
1-2 Years
2-3 Years
3-5 Years
5+ Years
Have You Ever Filed for Bankruptcy?
---------------------
No
Yes, Within the Last Year
Yes, Within the Last Three Years
Yes, Within the Last Five Years
Yes, Over Five Years Ago
Have
You Ever had a Repossession?
---------------------
NEVER
1 -Five Years Ago or Longer
1 -Within the Last Four Years
2 -Within the Last Four Years
3 -Within the Last Four Years
AUTO INQUIRY INFO:
Stock Number:
Location:
----------------
Garland
Rowlett
Trade In?:
YES
NO
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.