Please Note that * Denotes Required Field!
Please Indicate the Vehicle You Are Applying For :
 
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Down Payment Information : $
PERSONAL INFORMATION
*E-Mail Address:
Current Date:
*First Name: 
*Last Name:  
*Social Security Number: 
*Date Of Birth: (MM/DD/YYYY)
*Marital Status: 
Married Unmarried Separated
SPOUSE INFORMATION
Spouse's First Name: 
Spouse's S.S.N. #: 
Spouse's Date Of Birth: 
HOME OWNERS INFORMATION
*Home Address: 
*City: 
*State:
*Zip Code:
*Home Phone Number:
*How Long At Address Above:
 Years:  Months: 
Previous Address (If Less Than 3 Years):
Previous City:
Previous State:
How Long At Previous Address:
Years: Months:
*Nearest Relative (Not Living With You):
*Relatives Address:
*Relationship:
Spouse's Nearest Relative:
Relatives Address:
Relationship:
EMPLOYER INFORMATION
*Present Employer:
*Address:
*City:
*State:
*Zip Code:
*Business Phone:
*Position:
*Time At Current
Employer:
Years: Months:
*Income (Monthly):
$
Spouse's Employer Name & Address:
Spouse's Time At Current Employer:
Years: Months:
Spouse's Income:
PREVIOUS EMPLOYERS NAME & ADDRESSES
*Employer 1:

Years: Months:

Employer 2
(If Less Than 3 Years):

Years: Months:

Employer 3
(If Less Than 3 Years):

Years: Months:

BANKING INFORMATION
*Name Of Current Bank:
Do you have a checking account there?:
Do you have a savings account there?:
DEBT INFORMATION
*Home Type:
Rent  Own
*Amount Of Payment:
$
Car Make:
Car Year:
Lien Holder:
Amount Of Payment:
$
*Drivers License Number:
*Answer Yes or No to the Following:
REPOSSESSION:
Yes  No
BANKRUPTCY:
Yes  No 
GARNISHMENT:
Yes  No

PURCHASER'S STATEMENT

IMPORTANT NOTICE: Arizona is a "Community Property" state, which generally means that all property, goods, salaries, and debts acquired, earned, or contracted after marriage belong, by law, to the marital community. "Sole and Separate Property" is generally defined as those goods, property, income and debts acquired prior to marriage or inheritance after marriage.

Either spouse individually may manage the community property or bind the community to the payment of debt (generally). The Bank may require both spouses to sign certain loan documents necessary or thought necessary to create a valid lien or security interest under applicable Arizona law.

COMMUNITY PROPERTY DEBT: "This application, unless otherwise marked below, is to be considered as an application for credit extended as a debt of the marital community, based upon the creditworthiness of that community." Supply all information requested on the application.

SOLE AND SEPARATE PROPERTY: This is an application for individual credit as sole and separate debt, which will be evaluated without regard to the assets, income or creditworthiness of the applicant's spouse or the applicant's marital community. (The applicant should list only marital status and no other information should be given regarding the spouse (if any) except name and address. Applicant should also list all debts for which he/she is obligated by signing to promise to pay, and should also list all sole and separate assets and income.)

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