Credit Application - nickersonautosales.com

First Name

Middle Name

Last Name

Customer Address

pull Pay Text

Date of Birth

Social Security Number

Phone Number

Source of Income

Employer Name

Employer Address

Employer Phone Number

Monthly Rent/Mortgage- Expense

Gas Expense

Electric Expense

Water Expense

Car Note Expense

Phone Expense

Other Monthly Expenses

Reference 1- Family Member (cannot share same address)

Reference 1 – Address

Reference 1 – Phone Number

Reference 2 – Family Member (cannot share same address)

Reference 2 – Address

Reference 2 – Phone Number

Reference 3 – Friend (cannot share same address)

Reference 3- Address

Reference 3 – Phone Number

I authorize the dealership to pull my credit report. ( We do not pull credit for Buy Here Pay Here but may pull credit in the case of loan default.)

Single Line Text