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Grange Hill Road
Chadwicks, NY 13319
315-794-9243
info@undersellall.com

CREDIT APPLICATION

Please fill out the information below to find out if you qualify for financing. Fields in bold are required.

Personal Information

First Name:

Last Name:

Address:

City:

State:

Zip:

Social Sec. No.:

(000-00-0000)

Date of Birth:

(MM/DD/YYYY)

Phone:

E-mail:

Current Residence

Time at Residence: years, months

Rent or Own:

Payment Amount:

(per month)

Owed To:

(if mortgage)

Morgage/Landlord Phone #:

Previous Residence

Required when less than two years at current residence.

Address:

City:

State:

Zip:

Phone:

Time at Residence: years, months

Rent or Own:

Payment Amount:

(per month)

Current Employer

Employer Name:

Monthly Income:

Occupation/Title:

Address:

City:

State:

Zip:

Phone:

Time at Job: years, months

Previous Employer

Required when less than two years at current job.

Employer Name:

Monthly Income:

Occupation:

Address:

City:

State:

Zip:

Phone:

Time at Job: years, months

Co-buyer

Add a co-buyer

Desired Vehicle (optional)

Year:

Make:

Model:

Financing Information

Down Payment:

Trade In?: No Yes

Trade-in Year:

Trade-in Make:

Trade-In Model:

Trade-In Mileage:

Amount Owed on Trade-in:

Additional Comments

Comments:

Authorization I (purchaser/applicant) hereby expressly authorize the dealer, Centurion Financial, UACC, New City Funding, or any other financial institution authorized by the dealer, to obtain my credit report for the purposes of evaluating my creditworthiness and obtaining financing from third-party lenders for the purchase of a motor vehicle. I also certify that the above information is complete and accurate to the best of my knowledge.