Orange County Auto Broker - Credit Application
 
Instructions - Please Select Appropriate Box.
If you are applying for individual credit in your own name and are relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit requested, complete Sections A and C.
If you are married and live in a community property state, complete all Sections including Section B providing information about your spouse.
If this is an application for joint credit with another person, complete all Sections providing information in Section B about the co-applicant.

Purchase Lease
Email Address
Cell Phone

Seller
Stock No.
Date
Amount Requested
$


Section A
Last Name
First Name
Mid Init
Birth Date
Driver's Lic No
Social Security
- -
Ages of Dependents
Marital Status
Married Unmarried Separated
Address
City
State
Zip
How long have you lived at this address?
Home Phone
  

Previous Addresses (Going Back 5 Years)
Most Recent Address
City
State
Zip
How long have did live at this address?
How long did you live in this community?

Next Most Recent Address
City
State
Zip
How long have did live at this address?
How long did you live in this community?

Occupational Information
Occupation or Rank
Present Employer
  
Address
City
State
Zip
Phone Number
How long?
  

Previous Employment (Cover 5 Years)
Occupation or Rank
Present Employer
  
Address
City
State
Zip
Phone Number
How long?
  

Nearest Relative not Living with Applicant
Name
Relationship
Phone Number
Address
City
State
Zip

Income
Applicant's gross monthly income from employment:
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.
Alimony, child support, separate maintenance received under:
 Court Order
Written Agreement
Verbal Understanding
Amount of other montly income:
Total Monthly Income:


Section B: Information Regarding Spouse or Coapplicant
Last Name
First Name
Mid Init
Birth Date
Driver's Lic No
Social Security
- -
Ages of Dependents
Marital Status
Married Unmarried Separated
Address
City
State
Zip
How long have you lived at this address?
Home Phone
  

Previous Addresses (Going Back 5 Years)
Most Recent Address
City
State
Zip
How long have did live at this address?
How long did you live in this community?

Next Most Recent Address
City
State
Zip
How long have did live at this address?
How long did you live in this community?

Occupational Information
Occupation or Rank
Present Employer
  
Address
City
State
Zip
Phone Number
How long?
  

Previous Employment (Cover 5 Years)
Occupation or Rank
Present Employer
  
Address
City
State
Zip
Phone Number
How long?
  

Nearest Relative not Living with Applicant
Name
Relationship
Phone Number
Address
City
State
Zip

Income
Applicant's gross monthly income from employment:
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.
Alimony, child support, separate maintenance received under:
 Court Order
Written Agreement
Verbal Understanding
Amount of other montly income:
Total Monthly Income:

Section C: Asset and Debt Information

If Section B has been completed, this Section should be completed giving information about both the applicant and the Other Person.


Your Home
Own
Rent
Account No.
Mortgage Balance
Payment/Rent
Date Purchased
Age of Home
Price Paid
Market Value
2nd Mortgage
2nd Payment

Other Property 1
Open
Closed
Type of Credit
Company
Account No.
Address
City
State
Zip
Balance
High
Payment

Vehicles
Financed By
Account No.
Balance

Bank References
Bank
State
Branch/Address
 Checking
Savings
Balance
Bank
State
Branch/Address
 Checking
Savings
Balance

Have you ever had any property repossessed?
 Yes
No
Do you have any lawsuits pending against you?
 Yes
No
Have you ever filed bankruptcy or is a bankruptcy proceeding in progress or expected?
 Yes
No
Military Reserve?
 Yes
No 		Active
Inactive


Insurance

If you wish to apply for vehicle insurance in connection with this credit application, complete the following.

Notice: No person is required as a condition pursuant to financing the purchase of a motor vehicle to purchase insurance through a particular insurance company, agent, or broker.

Company/Agent
Address
City
State
Zip
Phone
Policy No.
  
Where will the vehicle be garaged?

 
Designed and Hosted by Enertia Solutions
© 2010, Fox Auto Consultants
Welcome | About  | Points of Consideration | FAQs | Credit Application | Testimonials | Used Cars | Affiliates | Mobility | Contact Us
Admin •  Sitemap •  Webmail
714.846.7599 • 17610 Beach Blvd #36, Huntington Beach, CA 92647