Applicant Form – Sorensen Auto Plaza

Date Taken: *

Max. Down Payment Ability *

Stk. No.

Year

Make

Model

Applicant Info

Applicant's Name *

First

Middle

Last

Nickname

Date of Birth *

Ages of Dependents

Email *

Mobile Phone# *

Home Phone#

Applicant's Current Residents

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Years at Current Address *

Ex: 1 year and 3 months

Own or Rent *

Own
Rent

Landlord/Mortgage Holder *

Landlord/Mortgage Phone# *

Description of Property *

Apartment, House, etc.

Monthly Rent/House Payment *

Previous Address

(If current living is less than 3 years)

Previous Address

Address Line 1

Address Line 2

City

State

Zip Code

Years Lived

Ex: 1 year and 3 months

Rent or Own

Rent
Own

Landlord/Mortgage Holder

Landlord/Mortgage Phone#

Previous Address 2

(If the two above address is less than 3 years combined)

Previous Address 2

Address Line 1

Address Line 2

City

State

Zip Code

Years Lived

Ex: 1 year and 3 months

Rent or Own

Rent
Own

Landlord/Mortgage Holder

Landlord/Mortgage Phone#

Employment History of Applicant

Current Employment *

Company Name

Hired Date *

Employer's Phone# *

Employer's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Supervisor's Name *

First

Last

Supervisor's Position *

Job Title- Position *

Pay Days *

Weekly, Bi-Weekly, Per Month, etc.

Former Employer

If current employment is less than 3 years.

Former Employment

Company Name

Hired Date

End Date

Former Employer's Address

Address Line 1

Address Line 2

City

State

Zip Code

Former Supervisor's Name

First

Last

Former Supervisor's Position

Former Employer's Phone#

Former Job Title- Position

Reason for Leaving

Other Sources of Income By Applicant

List of any additional income

Side Earnings from hobby, photography, etc.

Net Income per Month or Other

Co-Applicant Info

Applicant's Name

First

Middle

Last

Nickname

Date of Birth

Ages of Dependents

Email

Mobile Phone#

Home Phone#

Address

Address Line 1

Address Line 2

City

State

Zip Code

Years Living at Current Address

Ex: 1 year and 3 months

Own or Rent

Own
Rent

Landlord or Mortgage Holder

Landlord or Mortgage Holder Phone#

Description of Property

Apartment, House, etc.

Monthly Rent or House Payment

CO-Applicant's Previous Address

(If current living is less than 3 years)

Previous Address

Address Line 1

Address Line 2

City

State

Zip Code

Years Lived

Ex: 1 year and 3 months

Rent or Own

Rent
Own

Landlord or Mortgage Holder

Landlord or Mortgage Holder Phone#

CO-Applicant Previous Address 2

(If the two above address is less than 3 years combined)

Previous Address 2

Address Line 1

Address Line 2

City

State

Zip Code

Previous Address 2: Years Lived

Ex: 1 year and 3 months

Previous Address 2 : Rent or Own

Rent
Own

Previous Address 2: Landlord or Mortgage Holder

Previous Address 2: Landlord or Mortgage Holder Phone#

Employment History of CO-Applicant

Current Employment

Company Name

Hired Date

Employer's Phone#

Employer's Address

Address Line 1

Address Line 2

City

State

Zip Code

Supervisor's Name

First

Last

Supervisor's Position

Job Title- Position

Pay Days

Weekly, Bi-Weekly, Per Month, etc.

Former Employer of CO-Applicant

If current employment is less than 3 years.

Former Employment

Company Name

Hired Date

End Date

Former Employer's Address

Address Line 1

Address Line 2

City

State

Zip Code

Former Supervisor's Name

First

Last

Former Supervisor's Position

Former Employer's Phone#

Former Job Title- Position

Reason for Leaving

CO-Applicant's Other Sources of Income

List of any additional income

Net Income per Month or Other

Alimony, Child Support, or Separate Maintenance Income.

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 $

Banking Info

Do You Have an Existing Bank Account? *

Yes- Checking
Yes- Savings
No

How Long Have You Banked There?

Less than 6 Months
6-12 Months
Over 12 Months

Name of Bank

State & City Where Bank is Located

Bankruptcy

Have You Filed For Bankruptcy?

Yes
No

If yes. When?

Status of Bankruptcy Proceeding

Repossession

Have You Ever Had a Repossession? *

Yes
No

If Yes. How Many Repossessions Have You Had?

Date of Last Car Repossessed By:

Current Vehicle Info

Check All that Apply *

If "Other" was checked box, please give details here.

Estimated Miles Drive Per Week

Vehicle Financed / Leased by

Remaining Balance Left to Pay

Address of Financer or Leaser

Address Line 1

Address Line 2

City

State

Zip Code

Credit Info

Type of Credit

Bank, Store, etc.

Name of Lender

Is the Account Open or Closed?

Open
Closed

Address of Credit Location

Address Line 1

Address Line 2

City

State

Zip Code

Balance on Credit

Monthly Payment

Date When Completed

2nd Credit Info

Type of Credit

Bank, Store, etc.

Name of Lender

Is the Account Open or Closed?

Open
Closed

At least two (2) of the six (6) references must be relatives. Must fill in all six (6).

REFERENCE 1

Reference 1: Name

First

Last

Reference 1: Phone

Reference 1: Relationship

Reference 1: Address

Address Line 1

Address Line 2

City

State

Zip Code

REFERENCE 2

Reference 2: Name

First

Last

Reference 2: Phone

Reference 2: Relationship

Reference 2: Address

Address Line 1

Address Line 2

City

State

Zip Code

REFERENCE 3

Reference 3: Name

First

Last

Reference 3: Phone

Reference 3: Relationship

Reference 3: Address

Address Line 1

Address Line 2

City

State

Zip Code

REFERENCE 4

Reference 4: Name

First

Last

Reference 4: Phone

Reference 4: Relationship

Reference 4: Address

Address Line 1

Address Line 2

City

State

Zip Code

REFERENCE 5

Reference 5: Name

First

Last

Reference 5: Phone

Reference 5: Relationship

Reference 5: Address

Address Line 1

Address Line 2

City

State

Zip Code

REFERENCE 6

Reference 6: Name

First

Last

Reference 6: Phone

Reference 6: Relationship

Reference 6: Address

Address Line 1

Address Line 2

City

State

Zip Code

Household Info

Which of the Following are Living in Your Household? Check All that Apply *

If checked "Other" Explain.

What is Your Total Annual Household Income Before Taxes? *

What is Your Marital Status *

Married
Separated
Unmarried (Including Single, Divorced, Widowed)

How Did You Hear About Us? *

File Upload

Click or drag files to this area to upload. You can upload up to 3 files.

Agreement To Terms

Terms- You agree that we & any assignee of the financing contract or lease may monitor & record telephone calls regarding your account to assure the quality of our service or for other reasons. You agree that we & our assignees may try to contact you in writing, by email, or using prerecorded/artificial voice messages, text messages, & automatic telephone dialing systems, as the law allows. You also agree that we & our assignees may try to contact you in these & other ways of any address or telephone number you provide us, even if the telephone number is a cell phone number or the contact results in a charge to you. You (1) make the above representations, which are certified correct, for the purpose of securing cred; (2) authorise us, affiliated entities, & financial institutions to whom we submit your application (hereinafter "financial institutions") to obtain consumer credit reports & to gather employement history as necessary & appropriete to determine your credit worthiness; (3) understand that we or the financial institutions will retain this application whether or not it is approved, & that it is your responsibility to update changes of name, address, or employment. You are nottified pursuant to the Fair Credit Reporting Act, that your application may be submitted to SORENSEN AUTO FINANCE, INC. *

Yes, I have read the terms above and agree to them.

Date and Time of When Agreement of Terms Above Was Read.

Date

Time

Digital Signiture

READ THIS STATEMENT BEFORE SIGNING: I certify that the information supplied by me on this form is true & correct. I authorize verification of the truthfulness of all information contained herein, including contract with any person or firm listed above, & fully release all parties from all liability for any damage that may result. Any false statement made above shall be sufficient basis for rejection of this order.

I have read & understand the statement above.

Yes