:: TYPE OF LOAN ::

PLEASE SELECT LOAN REQUEST TYPE Individual Joint

* These fields MUST be completed in order to continue the application process.
:: BUYER PERSONAL INFORMATION ::

* FIRST NAME

* LAST NAME

* STREET ADDRESS

* CITY

STATE

ZIP

* EMAIL

* CONFIRM EMAIL

DAY PHONE

HOME PHONE

* SOC. SEC. NO.

DRIVERS LICENSE NO.

* DATE OF BIRTH

/ /

BEST TIME TO CONTACT

PREFERRED METHOD

* DO YOU

MONTHLY PAYMENT

MORTGAGE HOLDER OR LANDLORD

TIME AT RESIDENCE

YRS MO

:: BUYER EMPLOYMENT INFORMATION ::

EMPLOYER

POSITION/TITLE

 
JOB TIME

 

BUSINESS PHONE

BUSINESS ADDRESS

CITY

STATE

ZIP

GROSS ANN. SALARY $

 
OTHER INCOME SOURCE
(alimony, etc.)

MONTHLY INCOME $

:: BUYER CREDIT / PERSONAL REFERENCES ::

PREVIOUS EMPLOYER
/ SCHOOL

   
WILL YOU BE TRADING

YES  NO

AMOUNT OWED $

AUTO CREDIT REF.

 
OTHER CREDIT REF.

BALANCE

NEAREST RELATIVE

     
NAME

RELATIONSHIP

ADDRESS

PHONE

OTHER REFERENCE

     
NAME

PHONE

Ready to Apply for Credit?
Please complete our Credit Pre-Application as fully as you can so we can process your information as quickly and efficiently as possible.
   

Less Than Perfect Credit?
No worries! Harvest Ford Lincoln Mercury specializes in helping customers with "less than perfect" credit get the new vehicle they want. Complete the credit application and our Finance Managers will work with you to get you the best financing possible.

I certify that the above information is complete and correct. I authorize Harvest Ford Lincoln Mercury to obtain

credit reports about me and investigate my credit history. Please answer below.

YES NO