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									                                                                        E-Z Auto Loan Application


Name: Last: __________________________________
                                                                                                               For Sales Agent Use Only
              First:__________________________________
                                                                                              Vehicle:
              MI: _____ DOB: ___________ # Dep: ______
                                                                                                                      Year: __________________
              SSN: _________________________________
                                                                                                     PC Carbook Code: __________________
E-Mail Address: _______________________________
                                                                                                                      Make: __________________
Military Address: ____________________________
                                                                                                                     Model: __________________
              ________________________________________________
                                                                                              Requested Delivery: (Check One)
              Yrs at above Address: ___ Yrs of Svc: _______
                                                                                                                ___ Stateside          ___ Overseas
              Residency: ______ 1=Own Home Outright, 2=Buying Home
                                                3=Military Housing/Living w/Relatives
                                                4=Leasing/Renting
                                                                                              Pricing:
              Rent/Mtg Pmnt: $________________                                                          Total Delivered Price: $____________
              Mtg Co: _______________________________                                                      Deposit With Order: $____________
              Value: $_____________ Bal: $_____________                                                 (Credit Card Deposit) $____________
              Duty Phone: ____________________________                                                  (Credit Card Name)              ___________
              Home Phone: __________________________                                                                      Rebate: $____________
Stateside Address:___________________________                                                                Amount Financed: $____________
              ______________________________________                                                  Bal Due(30 Days Before Delivery): $____________
U.S.A. Phone Number: _________________________                                                                               Terms: _______
              Yrs at Above Address: ________                                                  Options:                                   ____ OPP ____ Ziebart
              Educ: _______ 1=4Yr College Grad, 2=2Yr College Grad                                                                       (Check All That Apply)
                                        3=Special Training, 4=Some College
                                        5=HS Grad, 6=Non HS Grad                              Credit Life Insurance:                     ____ Yes ____ No
              Branch of Svc: ____________ Rank: ________                                                                                 (Customer must initial)
Monthly Income*: $____________(Include only Base & BAS)
      *All Applications Must Be Accompanied By a Current LES.
                                                                                              Agent Name: Robert Davies
Other Income: _________________
                                                                                              Country Name: United Kingdom                    #: 024
          Source: _________________________________
* Alimony, child support, or spousal maintenance income need not be revealed, if you do not
                                                                                              Location Name: Lakenheath                #: 535
wish to have it considered as a basis for repaying this loan.

Name of Bank:_______________________________                                                          Agent #: 062
              Type of Acct: _________1=Checking & Savings,
                                                                                              Agent Signature: _______________________________
                                     2=Checking Only, 3=Savings only, 4=No Account
Previous Auto Loan:__________________________                                                 I authorize Overseas Military Sales Corporation and/or its subsidiaries
                                                                                              and affiliates to submit this application on my behalf to various financial
Other Expenses:                                                                               institutions for credit. I hereby authorize Overseas Military Sales
                                                                                              Corporation and/or its subsidiaries and affiliates and the designated
              Alimony: $________ Child Support: $________                                     finance institutions to receive and accept any personal and financial
                                                                                              information derived from financial credit reporting agencies or any
Personal References: (Name, Full Address, Phone, Relationship)                                other source for the sole purpose of assisting me in obtaining
                                                                                              necessary credit to purchase my new vehicle.
1)___________________________________________
_____________________________________________                                                 Customer Signature: ____________________________
_____________________________________________                                                                    Date: ________________
2)___________________________________________                                                                      For NY Office Use Only
_____________________________________________
                                                                                                     Date: ___________                    Tier: _________
_____________________________________________
                                                                                                  Income: ___________                    Ref #: _________
3)___________________________________________
                                                                                              Wholesale: ___________
_____________________________________________
                                                                                                                                                     Form#:FSGEZAPP(1/02)

								
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