262-642-4700   

 

Lynch Chrysler Dodge Jeep's 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, CFC, LMCU and Chase 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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