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    Dear Mike, Thanks so much for the call to check on us.  I actually had intended to call you and thank you again for meeting us.  It really helped me t Read More »

Joint Credit Application

Thank you for taking the time to fill out a credit application for Ruxer Ford Lincoln. Be assured that the information you submit is kept secure and confidential.

Note: * Indicates a required field.

 

Preferred Salesman:
Primary Applicant: Personal Information
First Name: *
Middle Initial: *
Last Name: *
Address: *
City: *
State: *
Zip: *
Time at Residence:*
Years: 

Months: 

Home Phone: *
E-mail: *
Date of Birth: *
Month: 

Day: 

Year: 

Social Security Number: *
Driver’s License Number: *
State:
Dwelling Information
Please Check One 

of the Following: *

  • Own Home Outright
  • Buying Home
  • Living with Relatives
  • Leasing/Renting
  • Own/Buying Mobile Home
  • Name of Landlord or 

    Mortgage Holder: *

    Address of Landlord or 

    Mortgage Holder: *

    Rent or Mortgage 

    Payment: *

    Co-Applicant: Personal Information
    First Name: *
    Middle Initial: *
    Last Name: *
    Address: *
    City: *
    State: *
    Zip: *
    Time at Residence:*
    Years: 

    Months: 

    Home Phone: *
    E-mail: *
    Date of Birth: *
    Month: 

    Day: 

    Year: 

    Social Security Number: *
    Driver’s License Number: *
    State:
    Dwelling Information
    Please Check One 

    of the Following: *

  • Own Home Outright
  • Buying Home
  • Living with Relatives
  • Leasing/Renting
  • Own/Buying Mobile Home
  • Name of Landlord or 

    Mortgage Holder: *

    Address of Landlord or 

    Mortgage Holder: *

    Rent or Mortgage 

    Payment: *

    Primary Applicant: Employer Information
    Your Current Employer:
    Employer Phone:
    Your Position:
    Time on Job:
    Years: Months:
    Gross Annual Income:

    Before Taxes

    Other Income:

    Co-Applicant: Employer Information
    Your Current Employer:
    Employer Phone:
    Your Position:
    Time on Job:
    Years: Months:
    Gross Annual Income:

    Before Taxes

    Other Income:

    Primary Applicant: Other Financial Information
    Have You Ever Had a Car or Other Merchandise Repossessed? * Yes 

    No

    If Yes, Date of Repossession:
    Have You Ever Had a Bankruptcy? Yes 

    No

    Co-Applicant: Other Financial Information
    Have You Ever Had a Car or Other Merchandise Repossessed? * Yes 

    No

    If Yes, Date of Repossession:
    Have You Ever Had a Bankruptcy? Yes 

    No

    Fair Credit Reporting Act Disclosure
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