Credit Application

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* Required Field

Application Type *

Personal Information

Applicant:

First Name *

Middle Name

Last Name *

Email Address *

Home Phone *

Work Phone *

Cell Phone *

Social Security #*

Date of Birth *

When should we contact you?

Employment Information

Applicant:

Employment Status *

Current Employer *

Title / Occupation *

Business Phone *

Time at Employer - Years *

Time at Employer - Months *

Gross Monthly Income *

Previous Employer *

Title / Occupation *

Time at Employer - Years *

Time at Employer - Months *

Co-Applicant

Employment Status

Current Employer *

Title / Occupation *

Business Phone *

Time at Employer - Years *

Time at Employer - Months *

Gross Monthly Income *

Previous Employer *

Title / Occupation *

Time at Employer - Years *

Time at Employer - Months *

Residential Information

Applicant:

Current Address *

Current Address Line 2

City *

State*

Zip Code *

Status *

Mortgage Payment / Rent *

Time at Residence - Years *

Time at Residence - Months *

Previous Address

Previous Address Line 2

City

State

Zip Code

Status

Mortgage Payment / Rent

Time at Residence - Years

Time at Residence - Months

Co-Applicant

Current Address *

Current Address Line 2

City *

State*

Zip Code *

Status *

Mortgage Payment / Rent *

Time at Residence - Years *

Time at Residence - Months *

Previous Address

Previous Address Line 2

City

State

Zip Code

Status

Mortgage Payment / Rent

Time at Residence - Years

Time at Residence - Months

Desired Vehicle

Filter Desired Vehicle

Year:

Make:

Model:

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Desired Vehicle *

Trade-In Vehicle

VIN

Year

Make

Model

Exterior Color

Mileage

Condition

Asking Price

Remaining Balance

Describe Vehicle Condition and History

Comments & Certification

Comments, References or Additional Information

I certify that the information provided by me is correct.
I certify that I am eighteen years of age or older.

I also understand that you will be checking with credit reporting agencies.
I authorize an investigation of my credit and employment history and the release of information about my credit experience.

Quick Contact

Dealership Info

Contact Us

Main Phone:

570-714-1980

Fax:

570-714-1986

Email:

sales@davesusedcarsales.com

Business Hours

Mon:	9 am- 6 pm
Tue:	9 am- 6 pm
Wed:	9 am- 6 pm
Thu:	9 am-6 pm
Fri:	9 am- 6 pm
Sat:	9 am- 3 pm
Sun:	Closed

Location

2008 Wyoming Ave
Wyoming, PA 18644