Welcome to Vans Auto Sales. We are eager to help you obtain your next automobile. Please fully complete your application for credit truthfully. This will allow us to better find a suitable lender for your unique situation. Name: Date of Birth: Social Security Number: Home # Cell # Email Address: Residential Info Current Address City/State/Zip Code How Long Renting or Buying Rent/Mtg Payment Name of Landlord/Mtg Holder Note: If more than 2 yrs. at current residence skip to Employment Info section. Previous Address City/State/Zip Code How Long? Employment Information Current Employer Occupation Address City/State/Zip Code Work Telephone # How Long? Gross Annual Income * If More than 2 yrs. at current job skip to Auto Credit section Previous Employer Occupation Address City/State/Zip Code Work Telephone # How Long? Auto Credit List any auto credit that may have not been reported to the Credit Bureaus Company Name High Credit $ Payment Amount $ Answer The Following Questions: Have you ever had a repossession or charge-off account with Vans Auto Sales? * Yes No Have you ever had a repossession or charge-off with any bank or finance company? * Yes No If YES, Where? Have you ever filed Bankruptcy? * Yes No If YES, When: Do you have 3 years of verifiable employment history? * Yes No Which vehicle(s) are you trying to obtain financing for? How much are you able to provide as a down payment on this vehicle? How Did You Hear About Us? Click down arrow and select from list Television Radio Newspaper Word of Mouth Internet Search By submitting this form, I give this dealer and it's financial affliates authorization to research my credit history for the purpose of financing this loan request. * Yes No Signature