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Email Address:
 
 Primary Applicant   
* First Name:
* Last Name:
* Address
* City
* State
* Zip Code
* Contact Phone
Ex: 111-222-3333
E-mail
Ex: myEmail@example.com
* Time at residence: Years  Months
* Monthly Pmt/Rent: $ 
If you do not pay rent or a mortgage, enter a zero.
*Date of Birth / /
*Social Security Number
Ex: 111-22-3333
*Employer's Name
If unemployed, type "unemployed".
*Employer's Phone Number
Ex: 111-222-3333. If unemployed, use your contact number.
*Occupation
*Time on Job  Years     Months
*Monthly Income
numbers only, please
 
  Use Joint Application    
* First Name:
* Last Name:
* Address
* City
* State
* Zip Code
Ex: 12345
* Contact Phone
Ex: 111-222-3333
E-mail
Ex: myEmail@example.com
* Date of Birth / /
mm/dd/yyyy
* Social Security Number
Ex: 111-22-3333
* Time at Residence Years  Months
* Do You Own   Rent   Other
* Rent/Mortgage
If you do not pay rent or a mortgage, enter a zero.
* Employer's Name
If unemployed, enter "unemployed".
* Employer's Phone Number
Ex: 111-222-3333. If unemployed, enter your contact number.
* Occupation
* Time on Job  Years     Months
* Monthly Income
 
 Vehicle of Interest   
Model Year:
Make:
Model:
Price: $
Numbers only, please. If you're not sure, leave this field blank.
Mileage:
Numbers only, please. If you're not sure, leave this field blank.
VIN:
If you're not sure, leave this field blank.
 Trade In   
Model Year:
Make:
Model:
Mileage:
Numbers only, please. If you're not sure, leave this field blank.
VIN:
If you're not sure, leave this field blank.
 
Important Info: Please Read!

I authorize Dealer ("you" and "your") and any finance company, bank, or other financial institution to which the Dealer submits my application to investigate my credit and employment history, obtain credit reports, and release information about your credit experience with me as the law permits.

If an account is created, I authorize you to obtain credit reports for the purpose of reviewing or taking collection action on the account, or for other legitimate purposes associated with the account.

* I certify that I have read and agree to the terms of this application and that the information in it is complete and true.

   
 
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Bill Fitts Auto Sales - 8421 Stagecoach Rd - Little Rock, AR 72210 - Phone: (501) 455-0612 - Toll Free: (866) 359-0636

 
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