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FAX this completed credit application to:  (805) 777-0726 50 N Skyline Dr - Thousand Oaks, CA 91362

1. Type your answers to credit application questions in corresponding blank fields and please answer all questions.
2. Please mark all that apply when answering multiple choice questions.
3. To print out application when completed - Right click on any yellow part of this application - Click 'PRINT'.
4. We MUST have a signed credit application for the credit check to be valid and legal - FAX TO: (805) 777-0726


: : :   BUYER'S INFORMATION   : : :

First Name: M.I.: Last Name:  Date of Birth: MO: DY: YR:
Social Security Number: -- Current Address: Number/Street: Apt No:

City: State: Zip Code:  Home Phone No: () - Years:

 Previous Address: Number/Street (If current is less than 3 years): Apt No:

City: State: Zip Code: Driver License No: State of Issue:

Nearest Relative Name: Address: Number/Street: Apt No:

City: State: Zip Code: Phone No: () - Relation:


: : :   EMPLOYER AND FINANCIAL INFORMATION   : : :

Current Employer:  Address: Number/Street: Unit No:

City: State: Zip Code: Phone No: () - Years:

Position: Gross Income ('X' Your Choice):  Monthly: Annually: $

>Other Source(s) of Income: (Applicant need not disclose income from alimony, child support or maintenance)

'X' Your Choice:  Monthly: Annually: $ Source(s):

>Previous Employer/ Education: (If current employment is less than 3 years)

Previous Employer or Degree: Address: Number/Street:

City: State: Zip Code: Phone No: () - Years:


Checking Account: Name of Institution: City: State:

 Savings Account: Name of Institution: City: State:

Name of Mortgage Holder/Landlord Name: Please 'X' Your Choice:  Own: Rent:

Address: Number/Street: City: State: Zip Code:

Approximate Value: $ Mortgage Balance: $ Mortgage or Rent Payment: $

Your Previous Vehicle is/was Financed with: City: State:
Account/Loan No: Monthly Payment: $ Loan Balance:
Credit Cards: (Balances Due) Visa: $ Master Card: $ Discover: $
Amex: $ Other Card: $ Other Card: $ Other Card: $
Credit Reference: Name: Address: Number/Street:
City: State: Approximate Balance: $ Monthly Payment: $
Ever File for Bankruptcy? ('X' Your Choice):  Yes: No: If Yes, What year?
Do You Pay Child Support or Alimony Payments? ('X' Your Choice):  Yes: No: Payment Amount: $
Are there any liens or judgments against you? ('X' Your Choice): Yes: No:
If so, please explain on a separate sheet of paper, typed or legibly handwritten.  Sign the attachment and Fax a copy along with this completed credit application. Thank you!

: : : JOINT APPLICANT AND/OR CO-SIGNER INFORMATION : : :

If joint applicant is a spouse, only those questions with an asterisk ( * ) are required to be completed.
*First Name: *M.I.: *Last:  *Date of Birth: MO: DY: YR:
*Social Security Number: -- Current Address: Number/Street: Apt No:
City: State: Zip Code:  Home Phone No: () - Years:
Previous Address: Number/Street (If current is less than 3 years): Apt No:
City: State: Zip Code: *Driver License No: *State of Issue:

: : : EMPLOYER AND FINANCIAL INFORMATION : : :

*Current Employer:  *Address: Number/Street: *Unit No:
*City: *State: *Zip Code: *Phone No: () - *Years:
*Position: *Gross Income ('X' Your Choice):  Monthly: Annually: *$

>Other Source(s) of Income: (Applicant need not disclose income from alimony, child support or maintenance)

*'X' Your Choice:  Monthly: Annually: *$ *Source(s):

>Previous Employer/ Education: (If current employment is less than 3 years)

*Previous Employer or Degree: *Address: Number/Street:
*City: *State: *Zip Code: *Phone No: () - *Years:

Checking Account: Name of Institution: City: State:
Savings Account: Name of Institution: City: State:
Name of Mortgage Holder/Landlord Name: Please 'X' Your Choice:  Own: Rent:
Address: Number/Street: City: State: Zip Code:
Approximate Value: $ Mortgage Balance: $ Mortgage or Rent Payment: $
Your Previous Vehicle is/was Financed with: City: State:
Account/Loan No: Monthly Payment: $ Loan Balance:
Credit Cards: (Balances Due) Visa: $ Master Card: $ Discover: $
Amex: $ Other Card: $ Other Card: $ Other Card: $
Credit Reference: Name: Address: Number/Street:
City: State: Approximate Balance: $ Monthly Payment: $
Ever File for Bankruptcy? ('X' Your Choice):  Yes: No: If Yes, What year?
Do You Pay Child Support or Alimony Payments? ('X' Your Choice):  Yes: No: Payment Amount: $
Are there any liens or judgments against you? ('X' Your Choice): Yes: No:
If so, please explain on a separate sheet of paper, typed or legibly handwritten.  Please indicate you are the Joint Applicant and/or Co-Signer, sign the attachment and Fax a copy along with this completed credit application. Thank you!

FAX Completed and Signed Application to: (805) 777-0726

To print out application when completed, right click on any yellow part of this application, then click 'PRINT'.
We MUST have a signed credit application for the credit check to be valid and legal | FAX TO: (805) 777-0726

______________________________________________________________________________________________________________________________________
I (we) certify that the above information is complete and accurate. I (we) authorize an investigation of my (our) credit and employment history and the release of any related information. I (we) authorize you to exchange credit information with others in connection with this application. I (we) have no outstanding obligations except as shown in this application and no undisclosed lawsuits or judgments are entered against me (us).
Date of Application:  MO: DY: YR:
_____________________________________________           _____________________________________________
 Applicant's Signature                                                                             Joint/Co-Applicant's Signature
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