903-340-5056
Canton,
Texas
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Applicant / Cosigner Information
*First Name, Middle Initial
*Last Name
*Email Address
*Day Phone Number
Evening Phone Number
Date of Birth
Jan
Feb
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Apr
May
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1915
1914
1913
1912
1911
1910
1909
*Social Security Number
-
-
*Driver's License
License Issued By Which State?
License Expiration Date
Are You a U.S. Citizen?
Yes
No
Employment Information
Employment Status
Employed Full Time
Employed Part Time
Self Employed
Temp Service
Unemployed
Student
Retired
Fixed Income
Homemaker
Other
Position
Employer
Employer Address
Employer City, State, Zip
Supervisor
Supervisor Phone Number
Employment Start Date
January
February
March
April
May
June
July
August
September
October
November
December
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
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1988
1987
1986
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1984
1983
1982
1981
1980
1979
1978
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1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
Gross Salary Before Taxes
$
per
Year
Month
Week
Previous Employment (if current less than 3 years)
Previous Employer
Previous Position
Previous Supervisor
Previous Employer Phone
Housing Information
Residence Status
Rent
Own
Military Housing
Live with Parents
Other
Residence Move-in Date
January
February
March
April
May
June
July
August
September
October
November
December
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
Address
City, State, Zip
state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Rent / Mortgage Payment
$
per month
Landlord / Mortgage Co. Name
Landlord / Mortgage Phone
Previous Housing (if current less than 3 years)
Previous Address
Previous City, State, Zip
Assets & Other Income (provide amount and source)
Cash or Savings
Other Income
REFERENCES: Family Members, Local if Possible
*Family Ref #1 Name, Phone
*Family Ref #1 Address
*Family Ref #1 City, State, Zip
*Family Ref #2 Name, Phone
*Family Ref #2 Address
*Family Ref #2 City, State, Zip
REFERENCES: Friends, Local if Possible
*Friend Ref #3 Name, Phone
*Friend Ref #3 Address
*Friend Ref #3 City, State, Zip
*Friend Ref #4 Name, Phone
*Friend Ref #4 Address
*Friend Ref #4 City, State, Zip
Loans or Other Obligations
(provide amount owed & monthly payments)
Other Auto Loans
Real Estate
Credit Card
Cosigner on Another Loan
Other (describe source)
Answer Yes or No.
(if yes, please explain in the comments box below)
Are you a part of a lawsuit?
Yes
No
Are there any outstanding judgments against you?
Yes
No
Have you ever or are you now preparing to declare bankruptcy?
Yes
No
Is any part of the down payment borrowed?
Yes
No
Are you paying alimony?
*
Yes
No
Are you paying / collecting child support?
*
Yes
No
Are you delinquent / in default on any federal debt, financial obligation, bond, or loan guarantee?
Yes
No
Have you had property foreclosed / repossessed or given title or deed in lieu thereof in the past 7 years?
Yes
No
Explain Any "Yes" Answers from Above
Terms : I hereby apply for the loan/credit on the appropriate vehicle. I certify that I made no falsifications or misrepresentations in this loan application or in any related documents, all information is true and complete, and did not omit any important information. I agree that any property securing the loan or credit will not be used for any illegal or restricted purpose. Lender is authorized to verify with other parties and to make any investigation of my credit, either directly or through any agency employed by Lender for that purpose. Lender may disclose to any other interested parties information as to Lender's experiences or transactions with my account. I understand that Lender will retain this application and any other credit information Lender receives, even if no loan or credit is granted. These representations and authorizations extend not only to Lender, but also to any insurer of the loan and to whom Lender may sell all or any part of this loan or credit. I further authorize Lender to provide to any such insurer or investor any information and documentation that they may request with respect to my application, credit or loan. You understand as a condition of sale, your vehicle will be equipped with an electronic tracking device installed on the vehicle that will be used to find the vehicle if you default on your contractual obligations.
*Alimony, Child Support, or other Separate Maintenance Income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.