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CREDIT EDUCATION PROGRAM (INTRODUCTION AND MODULES):
Special Financing
About Us
Refinancing
Car Payments
Loan Request Form
Our secure online form takes just 3 minutes to complete. Get started and drive today!
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1. Basic Information
Name
Zip Code
Monthly Income
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$1100/mo ($6.50/hr, $13k/yr, or less)
$1200/mo ($7.00/hr, $14k/yr)
$1300/mo ($7.50/hr, $16k/yr)
$1400/mo ($8.00/hr, $17k/yr)
$1500/mo ($8.50/hr, $18k/yr)
$1600/mo ($9.25/hr, $19k/yr)
$1700/mo ($9.75/hr, $20k/yr)
$1800/mo ($10.25/hr, $21k/yr)
$1900/mo ($11.00/hr, $23k/yr)
$2000/mo ($11.50/hr, $24k/yr)
$2100/mo ($12.00/hr, $25k/yr)
$2200/mo ($12.75/hr, $26k/yr)
$2300/mo ($13.25/hr, $27k/yr)
$2400/mo ($13.75/hr, $28k/yr)
$2500/mo ($14.25/hr, $30k/yr)
$2600/mo ($15.00/hr, $31k/yr)
$2700/mo ($15.50/hr, $32k/yr)
$2800/mo ($16.00/hr, $33k/yr)
$2900/mo ($16.75/hr, $35k/yr)
$3000/mo ($17.25/hr, $36k/yr)
$3100/mo ($17.75/hr, $37k/yr)
$3200/mo ($18.50/hr, $38k/yr)
$3300/mo ($19.00/hr, $39k/yr)
$3400/mo ($19.50/hr, $41k/yr)
$3500/mo ($20.00/hr, $42k/yr)
$3600/mo ($20.75/hr, $43k/yr)
$3700/mo ($21.25/hr, $44k/yr)
$3800/mo ($22.00/hr, $45k/yr)
$3900/mo ($22.50/hr, $46k/yr)
$4000/mo ($23.00/hr, $48k/yr)
Other
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2. Residential Information
Street Address
State
City
Zip Code
Do you rent or own your home?
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Rent
Own / Buying
Living with Family
Other
How long have you lived there?
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0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
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9 Years
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43 Years
44 Years
45 Years
46 Years
47 Years
48 Years
49 Years
50 Years
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0 Months
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11 Months
What is your monthly payment?
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$0.00
$100.00
$200.00
$300.00
$400.00
$500.00
$600.00
$700.00
$800.00
$900.00
$1000.00
$1100.00
$1200.00
$1300.00
$1400.00
$1500.00
$1600.00
$1700.00
$1800.00
$1900.00
$2000.00
$2100.00
$2200.00
$2300.00
$2400.00
$2500.00
$2600.00
$2700.00
$2800.00
$2900.00
$3000.00+
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Next
3. Employment information
Employment Type
Employee
Self Employed
Fixed Income
Employer Name
Time with Employer
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0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
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34 Years
35 Years
36 Years
37 Years
38 Years
39 Years
40 Years
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0 Months
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10 Months
11 Months
Occupation
Phone Number (optional)
Will you be able to provide pay stubs covering the last 30 days?
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Yes
No
Have You Filed For Bankruptcy in the Last 5 Years?
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No
Yes
Bankruptcy Chapter
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Chapter 7
Chapter 13
What Is Your Current Bankruptcy Status?
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Discharged (Completed)
Open (In Progress)
Dismissed (Incomplete)
Was Your Bankruptcy Discharged in the Last Year and a Half?
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No
Yes
Have You Had An Auto Repossession In The Last 12 Months?
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Yes
No
What Is The Maximum Down Payment You Can Afford?
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No Down Payment
$500 Down Payment
$1,000 Down Payment
$2,000+ Down Payment
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Next
4. Authorization & Certification
Social Security Number
Date of Birth
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Email
Primary Phone Number
Yes
I agree to the
Terms of Use
(including the
Supplemental Terms
) and
Privacy Policy
. I understand that your partners may obtain a credit report and I agree to receive Electronic Documents.
P
Check this box to add a co-buyer, or co-signer, to your loan request.
Name
Street Address
State
City
Zip Code
Date of Birth
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Email
Primary Phone Number
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