Credit Application - Prime Time Auto Lease

Full Name*

First Name Last Name

Date of Birth*

Ex. 02/28/1990

Driver License Number*

Social Security*

000-00-0000

Credit Score*

How long have you lived at your current address?*

Example: 1 Year and 5 Months

Current Address*

Street Address City State ZIP Code

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Current Address

This field is hidden when viewing the form

City / State

City State / Province

This field is hidden when viewing the form

Postal / Zip Code

Phone Number*

Ex. (000) 000-0000

Email*

[email protected]

Type of Residence*

Own
Renting
Live with relatives

Mortgage/Rent Amount*

Ex. $85000

How long have you lived at your previous address?*

Example: 1 Year and 5 Months

Previous Address*

City / State*

City State / Province

Postal / Zip Code*

Applicants Employment Information

Current Employer*

Years at Current Job*

Example: 1 Year and 5 Months

Position*

Employer Address*

Street Address Line 2*

City State / Province

Postal / Zip Code*

Employer Phone Number*

Ex. (000) 000-0000

Gross Monthly Income*

Ex. $85000

Other Income

Ex. $85000

Co-Applicant Information:

Co-applicant*

No
Yes

Full Name*

First Name Last Name

Date of Birth*

Ex. 02/28/1963

Social Security*

000-00-0000

Address*

How long have you lived at your current address?*

Example: 1 Year 5 Months

City / State

City State / Province

Postal / Zip Code*

Phone Number*

Ex. (000) 000-0000

Email*

[email protected]

Relationship to Applicant*

Ex. Daughter, Son, Nephew, etc.

Type of Residence*

Own
Renting
Live with relatives

Co-Applicant Employment Information

Current Employer*

Position*

Years at Current Job*

Example: 1 Year and 5 Months

Employer Address*

Street Address

City / State*

City State / Province

Postal / Zip Code*

Employer Phone Number*

Ex. (000) 000-0000

Gross Monthly Income*

Ex. $85000

Other Income

Ex. $85000

Fair Credit Reporting Act Disclosure

By Signing this document you agree to the following: I certify that the information I have provided on this application is, to the best of my knowledge, complete and accurate. I have read the Privacy Policy and authorize that my credit report is obtained. I am 18 years of age or older with a valid driver's license. I understand that financial institution(s) will rely on this information to judge my credit worthiness, and will retain this application and information about me whether or not this application is approved. Further, I authorize an investigation of my credit and employment history, in conjunction with which my credit report(s) may be obtained from one or more consumer credit reporting agencies. I understand that false statements may subject me to criminal penalties. I further understand that the Dealer and/or the financial institution(s) that evaluate my application may require additional information. I/We understand that this application for credit will be submitted by the Dealer to various financial institutions for evaluation.

Electronic Signature (by signing this, you are allowing access to your credit report)*

Vehicle of Interest*

Ex. Audi A4

How did you hear about us?*

Monday	9am > 9pm
Tuesday	9am > 9pm
Wendsday	9am > 9pm
Thursday	9am > 9pm
Friday	9am > 9pm
Saturday/Sunday	9am > 9pm