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Credit Application

Please complete the secured application form below to be considered for financing. All information is confidential and *fields marked with an asterisk are required.

APPLICANT INFORMATION

Last Name (or trade name of business)
First Name
Middle Initial
Suffix (Jr.)
Date of Birth	/ /
Soc. Sec. # (or tax id#)
Phone Number
Business Type (if applicable)	Corporation Partnership LLC Proprietorship
Present Address
City
State
Zip Code
# Years at Residence
# Months at Residence
Residence Type	Own Outright Buying Renting/Leasing Family Other
Monthly Mortgage Payment*

*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.

Present Job Title
Present Employer
Employer Phone Number
Time at Present Job	Years Months
Gross Income
Income Received	Monthly Yearly

CO-APPLICANT INFORMATION

Last Name (or trade name of business)
First Name
Middle Initial
Suffix (Jr.)
Date of Birth	/ /
Soc. Sec. # (or tax id#)
Phone Number
Business Type (if applicable)	Corporation Partnership LLC Proprietorship
Present Address
City
State
Zip Code
# Years at Residence
# Months at Residence
Residence Type	Own Outright Buying Renting/Leasing Family Other
Monthly Mortgage Payment*

*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.

Present Job Title
Present Employer
Employer Phone Number
Time at Present Job	Years Months
Gross Income
Income Received	Monthly Yearly

By completing the above form and filling in my name, I certify that the information in my application is complete and true. I authorize the dealer, GMAC, GMACNA, GMACAB, GMAC Automotive Bank (Corp. if New Mexico), C.O.L. Trust (if this is a lease application), Nuvell National Auto Finance and Nuvell Credit Company (if this is a purchase application) to investigate my credit and employment history, obtain credit reports, and release information about their credit experience with me. If an account is created, I authorize the obtaining of reports for purposes of reviewing or taking collection action on the account, or for other legitimate purposes associated with the account.


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