Credit Application -
  		Buyer
     
     Please enter the following information.  All required entries are notated by an *.  Once completed click on the
    SUBMIT button at the bottom of this page.

     Personal Information                                                                                                            Privacy Statement
 *First Name        Mi     *Last Name
         
 *Social Security #       *Birth Date
    
 Street #       Street Name                  
    
 Suite / Apt #      P.O. Box         R.R. #
      
 *City      *State     *Zip Code
       
 *How long have you lived at the above address?
  years    months   
 *Home Telephone #
 ()   - 
 *Email Address
 
 *Is there a co-applicant?
  Yes  No

     Employment and Income Information
 *Occupation
 
    (If applicable, indicate whether you're a student, retiree, or unemployed)
 Employer    How long have you worked there?
  years    months
 Work Telephone #
()   - 
 *Gross Monthly Income
$  
 Additional Monthly Income    Source(s) *
$   (Alimony, Child Support, Maintenance Income, etc.)

     Vehicle Information
Stock#      
Year    Make    Model

     Financing Information
 *Finance Amt       Desired Term    Preferred Monthly Pymt
$       $  
 Est. Down Pymt     Est. Trade-In Value    Trade-In Amt Owed        
$     $     $  
     
     Disclaimer
By submitting the above application, I / we certify that the information in my/our application is complete and true. I authorize Perl Auto Center Inc. and Third Parties to whom they forward the application to investigate my credit and employment history, obtain credit reports, and release information about their credit experience with me. If an account is created, I authorize the obtaining of credit reports for purposes of reviewing or taking collection action on the account or for other legitimate purposes associated with the account. I agree that you and any assignee of the financing contract may monitor and record telephone calls regarding my account to assure quality of service or for other reasons. I agree that you and my assignee of the financing contract may try to contact me in writing, by e-mail, or using prerecored/artificial voice messages, text messages, and automatic telephone dialing systems, as the law allows. I also agree that you and any assignee of the financing contract may try to contact me in these and othere ways at any address or telephone number I provide, even if the telephone number is a cell phone number or the contact results in a charge to me.