Individual Credit App

Personal Information (MUST MATCH DRIVER'S LICENSE)

Vehicle Stock #

First Name

Last Name

Suffix

SSN

DOB

Primary Phone

Cell Phone

Driver License No

State

Current Residence Information

Address (No P.O. Box Allowed)

Apt #

City

State

Zip

County

How Long? Years

Months

Status

Rent/Mortgage Pmt $

Landlord/Mortgage Co

Landlord/Mortgage Phone

Additional Address

Check box to enter Additional Mailing Address (different than Current/Physical Address)

Address

City

State

Zip

County

Current Employment Information

Status

Occupation

Employer Name

Address

City

State

Zip

Gross Salary $

Frequency

Work Phone

How Long? Years

Months

Second Job

Check box to enter a Second Job

Secondary Employment Information

Status

Occupation

Employer Name

Address

City

State

Zip

How Long? Years

Months

Work Phone

Gross Salary $

Frequency

Other Income Information

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Other Income Source

Explain

Gross Other Salary $

Frequency

Special Instructions

Authorization Signature *

By signing below you certify that the information provided is true and complete, and you authorize T&B Auto Sales and its lenders to obtain consumer credit reports and verify the information provided.

Sign Above