Bruised Credit Financing Application

Please complete this form.

Vehicle to Finance

Vehicle:

VIN:

Mileage:

Price:

Personal Information

First Name:

Middle Name:

Last Name:

Birth Date:

SSN:

E-Mail Address:

Street Address:

City, State Zip Code:

How Long at Residence:

Years Months

Residence Owned By:

Monthly Payment:

Landlord/Company:

Landlord Phone:

Home Phone:

Mobile Phone:

Work Phone:

Other Phone:

Checking Bank Name:

Savings Bank Name:

Employment Information

Employment Status:

Current Employers Name:

Employer's Address:

City, State Zip Code:

Job Title:

Salary:

Employer Phone:

Time on Job:

Years Months

Co-Applicant

Add Co-Applicant

Personal Information

First Name:

Middle Name:

Last Name:

Birth Date:

SSN:

E-Mail Address:

Street Address:

City, State Zip Code:

How Long:

Years Months

Residence Owned By:

Monthly Payment:

Landlord/Company:

Landlord Phone:

Home Phone:

Mobile Phone:

Work Phone:

Other Phone:

Checking Bank Name:

Savings Bank Name:

Employment Information

Employment Status:

Current Employers Name:

Employer's Address:

City, State Zip Code:

Job Title:

Salary:

Employer Phone:

Time on Job:

Years Months

Additional Information

Comments:

Agreement

I acknowledge that pursuant to the Fair Credit Reporting Act, my application will be submitted to a Lender or Lenders at Seller's discretion for review in connection with the assignment of a sales finance contract written, or to be written, in connection with my purchase. I certify that the above information is complete and accurate. In connection with this application, I authorize and give Seller my consent to obtain my credit report from any Credit Reporting Agency and complete an investigation of my credit and employment history and release information about my credit experience with Seller and/or Lenders. If and after my contract is assigned to a Lender, I also authorize and give consent to the assigned Lender to obtain my credit report from any Credit Reporting Agency at any time during the term of my contract for any purpose whatsoever, including but not limited to for prescreening, as defined and permitted from time to time by the Federal Trade Commission; for reviewing my contract; to defer or extend my payments or due date under my contract; to take collection action on my contract; or for other legitimate purposes associated with my contract. I understand and acknowledge that the Seller and Lender will retain this application whether or not it is approved. I also understand and acknowledge that if I ask, I will be informed if a credit report has been requested in connection with this application for credit, and the name and address of the Credit Reporting Agency that furnished the report. has been requested in connection with this application for credit, and the name and address of the Credit Reporting Agency that furnished the report.
									        
 By checking the box below on the online application or by signing the printed contract I authorize and give consent to Lender to use the email address and cellular telephone numbers I have provided on this application or which Lender obtains to communicate with me for any purpose whatsoever, including but not limited to communication regarding my account activity, status and to collect any debt obligation I owe to Lender. By providing a cellular telephone number on this application or to the Lender after my contract is assigned to them, I am consenting to receiving autodialed and artificial or prerecorded message calls from Lender or its third party debtor collector at those numbers. By checking the box below on the online application or by signing the printed contract I authorize and give consent to the Lender to discuss my account with my spouse, if applicable, including discussing my account activity, status and payment arrangements.

CA Applicants: If you are married, you may apply for a separate account.

OH Applicants: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

NY Applicants: In connection with your application for credit, a consumer report (credit report) may be requested. On your request, we will advise you if the report was actually ordered, and if so, the name and address of the agency that furnished the report.

WI Residents Only: Notice to Married Applicants: No provision of any marital property agreement, a unilateral statement under Wis. Stat. § 766.59 or a court decree under Wis. Stat. §766.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the creditor is incurred. The credit being applied for, if granted, will be incurred in the interest of my marriage or family. I understand that the creditor may be required by law to give notice of the credit transaction to my spouse.

ME Applicants: You are required by the terms of the contract to insure the motor vehicle which is the subject of this credit transaction. You have the right to free choice in the selection of the agent and insurer through or by which the insurance is to be placed, including the right to choose an agent or broker whether or not that agent or broker is affiliated with the creditor. Obtaining insurance products from a particular agent or broker does not affect credit decisions by the creditor regarding you, unless the insurance product violates the terms of the extension of credit regarding the adequacy of coverage or is otherwise not approved by the creditor.

By clicking submit, I certify that the information provided by me is complete, true and accurate. I also understand that you will be checking with credit report agencies. I authorize Rick Curren Auto Sales and its assigns to investigate my credit and employment history and to obtain consumer credit reports on me from one or more credit reporting agencies.

I have read and accept the above terms and conditions.