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CREDIT APPLICATION

Welcome to the Credit Application of Shop Autos Online.

All fields listed in RED are necessary in order for the form to be sent.

Applicant Personal Information
Co-Applicant?
First Name:
Middle Initial:
Last Name:
Address:
City:
State:
Zip Code:
Previous Address:
Previous City:
Previous State:
Previous Zip Code:
Home Phone:	( ) -
Cell Phone:	( ) -
Work Phone:	( ) - , ext.
Email
Social Sec. #:	- -
Date of Birth:	month day year

Applicant Residence Information
Residence Type:	Own Rent
How Long Here?	yrs. mos.
How Long at Prior Residence?	yrs. mos.

Applicant Employment Information
Employer:
Phone:	( ) -
Time with Current Employer:	yrs. mos.
Monthly Income (gross):
Current Job Title:
Previous Employer:
Phone:	( ) -
Time with Previous Employer:	yrs. mos.
Monthly Income (gross):
Previous Job Title:

Down Payment Information
Dollar amount available for Down Payment

Trade-In Information
Do you have a trade-in?	Yes No
Year of vehicle:
Make of vehicle:
Model of vehicle:
Payoff Amount:

Other Information
How did you hear about us?
I have read and fully understand the Privacy Disclaimer below.

Shop Autos Online Privacy Disclaimer
In connection with your transaction, we may obtain information about you as described in this notice, which we handle as stated in this notice.

We collect nonpublic personal information about you from the following sources:

- Information that we receive from you on applications or other forms
- Information about your transaction with us, our affiliates or others; and
- Information we receive from consumer reporting agency(s)

We may disclose all of the information we collect, as described above, to companies that perform marketing services on our behalf or to other financial institutions with whom we have joint marketing agreements. We may not make such disclosures about you as a consumer, customer, or former customer.
We may also disclose nonpublic personal information about you as a consumer, customer or former customer, to nonaffiliated third parties as permitted by law.
We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.