Individual Credit Application

Vehicle Information Type of Vehicle you are interested in: Year Make Model:	Trade-In Information Year Make Model: Mileage:
Borrower Information * required field First Name: Middle Initial: Last Name: Address: City: State: Zip: Date of Birth: Social Security Number: Day Phone: Evening Phone: E-mail: Fax: Best Time to Contact:
Housing Information Housing Status: Length of Residence: Mortgage/Rent Amount: Landlord or Mortgage Holder: Previous Address: Previous City: Previous State: Previous Zip: Previous Length of Residence: Previous Rent or Mortgage Amount:
Current Employment Employer: Employer Phone: Job Title: Time Employed: *Gross Monthly Income:
Previous Employment Previous Employer: Previous Employer Phone: Previous Job Title: Previous Time Employed:
Signature & Privacy Statement *Applicant Signature: *Date:
By submitting this credit application, I verify that the information provided is complete and accurate to the best of my knowledge. I further authorize an investigation of my credit and employment history. I also accept the terms of the Privacy Policy.

Car City Motor Company St. Joseph, Missouri