APPLICATION FOR CREDIT

Please complete all appropriate sections, providing at least two years residence and employment history.

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Applicant:

Residence address:
Previous address (if less than 5 years):


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OTHER INCOME: (Read to applicant) "Income form alimony, child support, or separate maintenance need not be revealed if you do not choose to rely on such income in applying for credit.")

Has applicant taken bankruptcy within last 7 years?

    
Bank Reference:


Personal Reference:

Are you a co-maker, endorser or guarantor on any loan or contract?

    
If Yes, to whom

Are you liable to pay alimony, child support, separate maintenance?

    
If Yes, to whom





Co-Applicant:

Residence address:


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$
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$
$
$
$
OTHER INCOME: (Read to applicant) "Income form alimony, child support, or separate maintenance need not be revealed if you do not choose to rely on such income in applying for credit.")

Has applicant taken bankruptcy within last 7 years?

    
Bank Reference:


Personal Reference:

Are you a co-maker, endorser or guarantor on any loan or contract?

    
If Yes, to whom

Are you liable to pay alimony, child support, separate maintenance?

    
If Yes, to whom


I authorize the Seller and its Assignee, Savannah best deals on 4 wheels, and its subsidiaries or affiliates, to make whatever inquiries it deems necessary in connection with this credit application and in the course of its review or collection of any credit extended in reliance on this application. I further authorise any person of consumer reporting agency to complete and furnish to the Seller and its Assignee, Savannah best deals on 4 wheels, Inc. And its subsidiaries or affiliates, any information that it may have or obtain in response to such inquiries, and agree that such information, along with this application, shall remain the Seller's and the Assignee's property, wherever or not the credit is extended. All information is declared to be a true representation of the facts and is made for the purpose of obtaining the credit requested. I acknowledge that my application for credit and any of the credit information you obtain will be submitted to Savannah best deals on 4 wheels. And/or its affiliates or subsidiaries.