SMZ Credit App

Credit Application

Please complete the form below:

Finance Information
Desired Loan Amount	*
Desired Monthly Payment	*

Personal Information
First Name	*
Last Name	*
SSN#	*	-* -*

Driver's License #	*
Driver's License Expiration	*	MM/YY/DD
Driver's License State	*
Date of Birth	*	/ /
Email Address	*
Daytime Phone Number	*	- * - * Phone Type Cell Landline

Evening Phone Number	*	- * - * Phone Type Cell Landline
Address	*
City	*
State / Province	*
Zip / Postal	*
Residence Type	*
Mortgage/Rent Payment		/ Per Month
Time At Residence	*	Years* Months* If Less Than 3 Years, Please List Prior Residency.

Previous Residence
Address
City
State / Province
Zip / Postal
Residence Type
Time At Residence		Years Months
Employment
Employer	*
Employer Address	*
Employer City	*
Employer State	*
Occupation
Years Employed	*
Salary	*	Per Month
NOTICE-BEFORE ASKING, APPLICANT MUST BE TOLD ONE NEED NOT REVEAL ALIMONY, CHILD SUPPORT OR SEPARATE MAINTENANCE IF ONE DOES NOT CHOOSE TO HAVE SUCH CONSIDERED IN THE BASIS FOR CREDIT.
Other Income	*	Per Month
Comments

Vehicle Interested In
Make
Model
Year
Down Payment Amount

Vehicle Trade In
Make
Model
Year
By submitting this application, I certify that all information herein is true and complete. I authorize lending institutions and this auto dealer to retain this application, to check and verify my credit, employment and salary history. By using our website, you authorize us to provide reports on the status of your application, including information concerning whether you pre-qualify for a loan, which lender's loan offer (if any) you choose to accept, whether your application for credit is denied, and whether you accept a loan from that lender.

I consent that by submitting this application, I authorize this dealership to check my credit.	*	Yes
Security Code	*