2340 S. Lamar
Austin, TX 78704
Phone: (512) 444-9999
Fax: (512) 442-0600
APPLICATION
TODAY’S DATE:______________
FULL NAME:_________________________________________ DATE OF BIRTH: _____________________
SOCIAL SECURITY#:_______________________ DL #/STATE_________________________
STREET ADDRESS:_____________________________________ PHONE NUMBER:____________________
CITY:__________________________ STATE:_____________ ZIP:_______________
HOW LONG AT THE PRESENT ADDRESS: YEARS:_____________ MONTHS: __________
HOME: RENT( ) OWN( ) MONTHLY PAYMENT: ____________________
LANDLONRD/MORTAGE COMPANY NAME: ________ __________________ PHONE #:__________________
NAME ON ELECTRIC BILL: ___________________________NAME ON GAS BILL: _______________________
SPOUSE NAME: _______________________________ SPOUSE EMPLOYER: ___________________________
SPOUSE SOCIAL SECURITY #:_____________________ OTHER INCOME: $__________ SOURCE:___________
HAVE YOU EVER FILLED BANKRUPTCY: YES ( ) NO ( ) IF YES, WHEN:__________________________________
HAVE YOU EVER HAD A REPOSSESSION? YES ( ) NO( ) IF YES, WHEN:________________________________
WILL THERE BE ANY OTHER PERSON(S) DRIVING THE VEHICLE BESIDES YOU?
YES ( ) NO ( ) IF YES, NAME OF ADDITIONAL DRIVER: ____________________________________________
TWO YEAR OF RESIDENCE (LAST TWO)
TIME OF RESIDENCE: FROM:________________TO: _______________ (circle one) RENT OWN
ADDRESS:_____________________________________CITY/STATE/ZIP:______________________________
LANDLORD/MORTAGE COMPANY:__________________________________ TELEPHONE#:_______________
TIME OF RESIDENCE: FROM:________________TO: _______________ (circle one) RENT OWN
ADDRESS:_____________________________________CITY/STATE/ZIP:______________________________
LANDLORD/MORTAGE COMPANY:__________________________________ TELEPHONE#:_______________
THREE YEAR HISTORY OF EMPLOYMENT (LAST THREE)
EMPLOYER:_____________________________ FROM:________________ TO: ________________
ADDRESS:____________________________________________ PHONE #:_____________________
CITY/STATE/ZIP: _______________________________________
POSITION/MONTHLY INCOME:__________________ SUPERVISOR:__________________________________
EMPLOYER:_____________________________ FROM:________________ TO: ________________
ADDRESS:____________________________________________ PHONE #:_____________________
CITY/STATE/ZIP: _______________________________________
POSITION:_____________________________ SUPERVISOR:__________________________________
EMPLOYER:_____________________________ FROM:________________ TO: ________________
ADDRESS:____________________________________________ PHONE #:_____________________
CITY/STATE/ZIP: _______________________________________
POSITION:_____________________________ SUPERVISOR:__________________________________
I authorize the making of whatever credit inquiries are deemed necessary in connection with my credit
application or in the course of collection of any credit extended in reliance on the application. I authorize
and instruct any person or consumer reporting agency to furnish any information it may have or obtain in
response to such credit inquiries and agree that same shall remain your property whether or not credit is
extended.
I HAVE READ THE FOREGOING APPLICATION AND THE STATEMENTS MADE ARE TRUE AND CORRECT.
Falsifying information on this credit application will result in default of your contract without notice and
repossession of vehicle purchased.
DATE: _______________________ X __________________________________
SIGNATURE OF APPLICANT
REFERENCE SHEET
SALES REP.:____________________ CUSTOMER:__________________________
*MUST HAVE PARENTS, IMMEDIATE FAMILY MEMBERS, CLOSE FRIENDS.
*MUST BE AT DIFFERENT ADDRESSES AND MUST HAVE HOME PHONE #.
FOUR (4) RELATIVES
________1. NAME:_____________________________________________________________________
ADDRESS:_____________________________ CITY:_________ STATE:_______ ZIP:________
HOME #:(_____)________________________ WORK #:(_____)________________________
RELATIONSHIP:_________________________ HOW LONG?: __________________________
________2. NAME:_____________________________________________________________________
ADDRESS:_____________________________ CITY:_________ STATE:_______ ZIP:________
HOME #:(_____)________________________ WORK #:(_____)________________________
RELATIONSHIP:_________________________ HOW LONG?: __________________________
________3. NAME:_____________________________________________________________________
ADDRESS:_____________________________ CITY:_________ STATE:_______ ZIP:________
HOME #:(_____)________________________ WORK #:(_____)________________________
RELATIONSHIP:_________________________ HOW LONG?: __________________________
________4. NAME:_____________________________________________________________________
ADDRESS:_____________________________ CITY:_________ STATE:_______ ZIP:________
HOME #:(_____)________________________ WORK #:(_____)________________________
RELATIONSHIP:_________________________ HOW LONG?: __________________________
FOUR (4) FRIENDS
________1. NAME:_____________________________________________________________________
ADDRESS:_____________________________ CITY:_________ STATE:_______ ZIP:________
HOME #:(_____)________________________ WORK #:(_____)________________________
RELATIONSHIP:_________________________ HOW LONG?: __________________________
________2. NAME:_____________________________________________________________________
ADDRESS:_____________________________ CITY:_________ STATE:_______ ZIP:________
HOME #:(_____)________________________ WORK #:(_____)________________________
RELATIONSHIP:_________________________ HOW LONG?: __________________________
________3. NAME:_____________________________________________________________________
ADDRESS:_____________________________ CITY:_________ STATE:_______ ZIP:________
HOME #:(_____)________________________ WORK #:(_____)________________________
RELATIONSHIP:_________________________ HOW LONG?: __________________________
________4. NAME:_____________________________________________________________________
ADDRESS:_____________________________ CITY:_________ STATE:_______ ZIP:________
HOME #:(_____)________________________ WORK #:(_____)________________________
RELATIONSHIP:_________________________ HOW LONG?: __________________________
MUST ALSO PROVIDE:
1. DRIVERS LICENSE
2. SOCIAL SECURITY CARD
3. PROOF OF INCOME
4. PROOF OF RESIDENCE
5. TELEPHONE, UTILITY, CABLE BILL
6. PROOF OF FULL COVERAGE INSURANCE
If spouse or any other person is to be contractually liable for this debt, such person should complete an
additional credit application