Credit Application - DEKALB MOTORWORKS LLC
Email Address:
 
 Primary Applicant   
* First Name:
Middle Initial:
* Last Name:
*Date of Birth
Applicants must be at least 18 years of age
*Social Security Number
* Contact Phone
E-mail
 
  Residence
* Address
* City
* State
* Zip Code
* Time at residence: Years  Months
* Monthly Pmt/Rent: $ 
If you do not pay rent or a mortgage, enter a zero.
 
Driver License
* License Number
* License State
* License Expiration
 
Employment History
 
*Employer's Name
*Employer's Phone Number
Ex: 111-222-3333. If unemployed, use your contact number.
*Occupation
*Time on Job  Years     Months
*Monthly Income
Gross Pay, Before Taxes (numbers only)
 
     
* First Name:
Middle Initial:
* Last Name:
* Date of Birth
Applicants must be at least 18 years of age
* Social Security Number
* Contact Phone
E-mail
 
Residence
* Address
* City
* State
* Zip Code
* Time at Residence Years  Months
* Do You Own   Rent   Other
* Rent/Mortgage
If you do not pay rent or a mortgage, enter a zero.
 
Driver License
* License Number
* License State
* License Expiration
 
Employment History
         
* Employer's Name
* Employer's Phone Number
* Occupation
* Time on Job  Years     Months
* Monthly Income
Gross Pay, Before Taxes (numbers only)
 
 Vehicle of Interest   
Model Year:
Make:
Model:
Price: $
Numbers only, please. If you're not sure, leave this field blank.
Mileage:
Numbers only, please. If you're not sure, leave this field blank.
VIN:
If you're not sure, leave this field blank.
 Trade In   
Model Year:
Make:
Model:
Mileage:
Numbers only, please. If you're not sure, leave this field blank.
VIN:
If you're not sure, leave this field blank.
 
Important Info: Please Read!

I authorize Dealer ("you" and "your") and any finance company, bank, or other financial institution to which the Dealer submits my application to investigate my credit and employment history, obtain credit reports, and release information about your credit experience with me as the law permits.

If an account is created, I authorize you to obtain credit reports for the purpose of reviewing or taking collection action on the account, or for other legitimate purposes associated with the account.

*

   
 
 
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