PERSONAL INFORMATIONFirst Name*Middle NameLast Name*Date of Birth*Social Security Number*Citizenship*—Please choose an option—US PassportGreen CardSSN, Work PermitWork VisaTourist VisaOtherEmail*Cell Phone*TELL US ABOUT YOUR CARWhat car are you looking for:Preferred exterior colors:Preferred interior colors:Do you want to lease or finance:—Please choose an option—LeaseFinanceCashHelp me to choosePLEASE SELECT YOUR OPTIONSHave you leased/financed cars before:—Please choose an option—YESNOWhat car do you have now: List all cars registered on your name or members of your household. You may qualify for additional discounts. What is your credit score:—Please choose an option—No SSNNew SSN, no credit cardsUnder 600600-650650-700Over 700I dont knowCHOOSE YOUR PERSONAL AUTO BROKER—Please choose an option—Alex Damaratski ADDRESS INFORMATIONAddress*City*State*—Please choose an option—FloridaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingTerritories – GuamTerritories – Puerto RicoZip*Time at Current Residence*—Please choose an option—<1 year1 year2 years> 2 yearsDo you rent or own your residence?*—Please choose an option—RentOwnLive with relativesMonthly Payment*Previous Address (If less than 2 years at current address)CityState—Please choose an option—FloridaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingTerritories – GuamTerritories – Puerto RicoZipEMPLOYMENT INFORMATIONCurrent Employer’s Name*Position Or Title*Business phone*Current Employer’s Address*City*State*—Please choose an option—FloridaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingTerritories – GuamTerritories – Puerto RicoZip*How Long*—Please choose an option—<1 year1 year2 years> 2 yearsMonthly Income, $ *Other Income, $UPLOAD DOCUMENTSClick here to upload your Driver License*SIGNATURESFAIR CREDIT REPORTING ACT TO CONSUMER. This will advise you that your retail installment sales contract and buyer’s application for secured debt will be submitted to financial institutions and their affiliates for purchase and consideration as to whether you meet their credit requirements. The undersigned futhers authorized these financial institutions and their affiliates to obtain such information that they may required in order to verify information relative to this request including contacting spouses to verify spouse related information. I certify that all information given me on this application is complete and accurate. I give my permission for any financial institution which will review this credit application, to investigate my credit and employment history, and to answer questions about their credit experience with me including but not limited to late payments, missed payments or other defaults, and this information may be reported in your credit report.I have read & accept I’ve read and accept the Privacy Policy.Printed Name*Initials*Date Of Signature*Sign Here* Do you have a co-applicant? YesNo Business Credit Application YesNoCOMPANY INFORMATIONCompany Name*Year Established*Company Ein*Type Of Business Activity*Type Of Business(Incorporated, LLC, Partnership, other)Number Of EmployeesEmail*Work Phone*Address*City*State*—Please choose an option—FloridaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingTerritories – GuamTerritories – Puerto RicoZip*Officer 1 (First, Last Name)*% Ownership*Title*Officer 2 (First, Last Name)% OwnershipTitleOFFICER 3 (First, Last Name)% OwnershipTitleCo-Applicant’s informationFirst Name*Last Name*Date of Birth*Social Security Number*Email*Cell Phone*Relationship to Applicant*Address*City*State*—Please choose an option—FloridaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingTerritories – GuamTerritories – Puerto RicoZip*Time at Current Residence*—Please choose an option—< 1 year1 year2 years>2 yearsDo you rent or own your residence?*—Please choose an option—RentOwnLive with relativesMonthly Payment*Previous Address (If less than 2 years at current address)CityState—Please choose an option—FloridaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingTerritories – GuamTerritories – Puerto RicoZipEMPLOYMENT INFORMATIONCurrent Employer’s Name*Position Or Title*Business phone*Current Employer’s Address*City*State*—Please choose an option—FloridaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingTerritories – GuamTerritories – Puerto RicoZip*How Long*—Please choose an option—<1 year1 year2 years> 2 yearsMonthly Income, $ *Other Income, $UPLOAD DOCUMENTSClick here to upload your Driver License*SIGNATURESFAIR CREDIT REPORTING ACT TO CONSUMER. This will advise you that your retail installment sales contract and buyer’s application for secured debt will be submitted to financial institutions and their affiliates for purchase and consideration as to whether you meet their credit requirements. The undersigned futhers authorized these financial institutions and their affiliates to obtain such information that they may required in order to verify information relative to this request including contacting spouses to verify spouse related information. I certify that all information given me on this application is complete and accurate. I give my permission for any financial institution which will review this credit application, to investigate my credit and employment history, and to answer questions about their credit experience with me including but not limited to late payments, missed payments or other defaults, and this information may be reported in your credit report.Printed Name*Initials*Date Of Signature*Sign Here*