THE USAUTOMART :: 2006

For specific financing questions and/or concerns, please contact
our Finance Department today at (724)523-6868!

Credit Application

APPLICANT COMPLETES THIS SECTION
Last Name or Business Name:
First Name:
Middle Initial:
Date of Birth:

Social Security # or Tax ID:
Mother's Maiden Name:

Home Phone (with area code):
Day Phone (with area code):
Fax:
E-Mail:
How did you hear about us?

Home Ownership:
Current Street Number:
Current Street Name:
PO Box Number:
City:
State:
Zip Code:
Time at Address Yrs:	Months:
MTG Payment or Monthly Rent::

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.
Gross Annual Income:
Time Employed Yrs:	Months:
Military Rank:
Employed By:
Employer's Phone #:
Occupation:
If you have been employeed for less than 2 years at your current employer, please fill out the section below:
Previous Gross Annual Income:
Previous Time Employed Yrs:	Months:
Previous Military Rank:
Previous Employer:
Prev. Employer's Phone #:
Previous Occupation:

DESIRED VEHICLE DESCRIPTION
Type of Vehicle Wanted:
Demo?: Off-Lease Vehicle?:
Estimated Down Payment:
Desired Monthly Payment:
Desired Make:
Desired Model:
List Desired Options:
Enter Additional Comments Here:

VEHICLE TRADE-IN DESCRIPTION
Type of Vehicle:
Year:
Make:
Model:
Mileage:
Monthly Payment:
Amount Owed:
List Options:
Enter Additional Comments Here:

CO-APPLICANT COMPLETES THIS SECTION
Last Name or Business Name:
First Name:
Middle Initial:
Date of Birth:
Co-Applicant Social Security # or Tax ID:

Day Phone (with area code):
Home Phone (with area code):
Fax:
E-mail Username:

Home Ownership:
Current Street Number:
Current Street Name:
PO Box Number:
City:
State:
Zip Code:
Time at Address Yrs:	Months:
MTG Payment or Monthly Rent::

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.
Gross Annual Income:
Time Employed Yrs:	Months:
Military Rank:
Employed By:
Occupation:

SIGNATURES
This application will be submitted to USAutomart Financing Institutions so that they may decide whether or not to purchase the transaction. Unless you check the box below, you will authorize the dealer and their finance affiliates to share and use information about you, including information in my application, with other entities that are related to them by common ownership or affiliated with them by common control. I direct the dealer and their finance affiliates to NOT share and use information about me (other than information on their own transactions or experiences with me). By checking the box below, I certify that the information in my application is complete and true. I authorize the dealer and their finance affiliates to investigate my credit and employment history, obtain credit reports, and release information about their credit experience with me. If an account is created, I authorize the obtaining of credit reports for purposes of reviewing or taking collection action on the account, or for other legitimate purposes associated with the account. I authorize that all information is complete and true. I authorize the dealer and their finance affiliates to investigate my credit and employment history, obtain credit reports, and release information about their credit experience with me. If an account is created, I authorize the obtaining of credit reports for purposes of reviewing or taking collection action on the account, or for other legitimate purposes associated with the account. By sending this e-mail, I am agreeing to the aforementioned terms and conditions.
Name of nearest relative not living with you:
Address of relative:
Phone:

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**Over 30 banks and lenders in our lending network!