Car Loan Application Form

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CAR LOAN APPLICATION FORM
Name:
______________________________________________________________________________
(First)
(Middle)
(Last)
Address:
______________________________________________________________________________
(Street)
APT #
(City)
(State and Zip)
Phone:
______________________
__________________________
_______________________
(Daytime)
(Evening)
(Cellular)
Date of Birth: _ _ / _ _ / _ _ _ _ Social Security #: _ _ _ - _ _ - _ _ _ _ Email: ___________________________
Employer: ______________________________ Title: _____________________ Phone: __________________
Length of time at job: _________ Salary: (hourly wage) ________ Monthly Gross Income: _________________
Own or Rent Home: Own ___ Rent ___ Monthly Payment: ________ Total Monthly Expenses: ______________
Loan Type: Used Car ____ New Car _____ Loan Amount: $_______________ Term: 1 / 2 / 3 years
Down payment Amount: $ ____________________. Do you have a co-signer available: Yes_____ No _____
Have you filed Bankruptcy in the past 7 years? Yes ____ No _____ Please explain ________________________
___________________________________________________________________________________________
Status: Single __ Married __ Separated __ Divorced __ Permission for Electronic Fund Transfer: Yes __ No __
Emergency Contact Information
Name: ____________________________
Phone #________________________
Name: ____________________________
Phone #________________________
Financial References
Bank/Institution
Account Number
Checking Account
Savings Account
Permission to Obtain Consumer Credit Report
By signing this application form, I hereby give the ECDC Enterprise Development Group (EDG) the right to obtain a consumer
credit report regarding me for this application and the life loan should my application be approved. I also release from all liability all
persons, companies, and corporations supplying such information. I indemnify the EDG against any liability that might result from
making such an investigation.
I certify that the information above is correct to the best of my knowledge. I authorize EDG to make inquiries as necessary to verify
the accuracy of the statements made by me and to determine my creditworthiness. I have read and understand the fees outlines
above. I agree to indemnify and hold harmless EDG, its officers, directors, employees, agents and volunteers from any and all
claims, loss or other liability arising from or related to the services that EDG provides before, during, and after the loan review
process. I agree to pay the required sums and I agree to be bound by the loan agreement, if my application is accepted.
Loan Application Fee = $50
Loan Amount Approved
Closing Cost (Processing Fee)
$1,000 - $5,000
$ 100
$5,001 - $8,000
$ 150
________________________________
___________________
Applicant Signature
Date
FOR EDG INTERNAL USE ONLY
Date Application Received: _________________ Received by: ___________________________________

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