AUTO LOAN APPLICATIONCG Auto Plex 861 W Gila Bend Hwy Casa Grande, AZ 85122 - (520) 836-3975 - cgautoplex.com

Available Down Payment

Applicant name

Marital Status

Married

Single

Divorced

Email

Social Security #

Phone

Own or Rent

How Long

Monthly payment

Vehicle Interested In

Address

Employment Information

Amount Requested For Loan

Occupation

Hire Date

Employers Address

Employers Address

Income Monthly

Amoutn you earn each month before taxes

Other Income

Other Income

* Co-Applicant Information ( if applicable)

Name

Date Of Birth

Email

Social Security #

Address

Phone

Own / Rent

Own

Rent

How Long

Monthly payment

Marital Status

Married

Single

Divorced

Amount Requested

Do you have a checking, savings or prepaid card?

Checking

Savings

Prepaid Card

none

How long?

Bankruptcy last 10 years?

Yes

No

If Yes to Bankruptcy, What type?

7

11

13

Is Bankruptcy discharged?

Yes

No

Surrender | Auto Repossessed ?

Yes

No

Date

How should we contact you?

Phone

Email

Either is fine

Applicant Signature

Date

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