Auto Select - St. Augustine, FL

CREDIT APPLICATION

Please complete the form below and click the "Agree" button. All fields marked * are required fields.

Applicant Information

Please complete the form below and click the "Agree" button.

First Name *

Middle Name

Last Name *

Current Address *

City *

State *

Zip Code *

Residency Information

Years at Residence

Months at Residence

Monthly Payment

Phone *

Mobile Phone

Email *

Driver's License

State of Issue

Expire Month

Expire Day

Expire Year

Birth Month *

Birth Day *

Birth Year *

Social Security Number *

Applicant Employment

Employer

Occupation

Employment

Employer Address

City

State

Zip Code

Work Phone

Years on Job

Month on Job

Gross Salary

Per

I would like to add Co-Applicant

Co-Applicant Information

Joint Credit

First Name

Middle Name

Last Name

Current Address

City

State

Zip Code

Phone

Mobile Phone

Driver's License

State of Issue

Expire Month

Expire Day

Expire Year

Birth Month

Birth Day

Birth Year

Social Security Number

Co-Applicant Employment

Employer

Occupation

Employment

Employer Address

City

State

Zip Code

Work Phone

Years on Job

Month on Job

Gross Salary

Per

Authorization

Please read this information carefully and print a copy and/or retain this information electronically for future reference.

TERMS AND CONDITIONS

By completing this secure, online Credit Application and clicking "Accept" / "Submit" you certify that all information herein is true, complete, and you have read the Privacy Policy stated below and you authorize us the dealer to begin a credit investigation, including obtaining your consumer credit report, employment history, creditors' experiences with you as a consumer and to forward or allow direct electronic access, your application to lenders, financial institutions, or other third parties in order to process your application. We may retain the application, and will contact you by telephone or email with regards to your application.

PRIVACY POLICY
1. We collect nonpublic personal information about you from the following sources:
• Information we receive from you on applications or other forms in connection with a financial transaction;
• Information about your transactions with us, our affiliates, or others; and
• Information we receive from a consumer reporting agency.

2. We may disclose the information we collect, as described above, to our affiliates, to other financial institutions with whom we have joint marketing agreements, or to companies that perform services or functions on our behalf. These companies may include financial service providers and non-financial companies such as computer and data processing companies, and marketing and aftermarket service providers. These companies will be contractually obligated to keep the information we provide them confidential and to use the information only to provide the services requested of them. We observe limits and restrictions set by law as to sharing of information with our affiliates or others.

3. We may disclose nonpublic, personal information about you as a consumer, customer or former customer, to nonaffiliated third parties as permitted by law.

4. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

STATE SPECIFIC DISCLOSURES

• For Maine Applicants
You have the right of free choice in the selection of the agent and insurer through or by which insurance in connection with a loan is to be placed. Obtaining insurance products from a particular agent or broker does not affect credit decisions by the lender.
• For New York Applicants
A consumer report may be requested in connection with your application. Upon your request, we will tell you whether or not the consumer report was requested and give you the name and address of the consumer reporting agency that furnished the report.

• For Ohio Applicants
The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

• For Wisconsin Applicants
Wisconsin law provides that no provision of a marital property agreement, a unilateral statement under the marital property law, or a court decree, will adversely affect a creditor ’s interests unless the creditor, prior to the time the credit is granted, is furnished with a copy of the agreement, statement or decree or has actual knowledge of the adverse provision. If you are making this application individually and not jointly with your spouse, you understand that Wisconsin law requires that your spouse be given notice of this credit obligation.

• For Delaware Applicants
Notification - Every licensee shall furnish to every applicant, a copy of this regulation at the time when such application is made. Posting of this regulation in the office of the licensee in a place both prominent and easily visible to all potential applicants shall satisfy this requirement. An explanation as to the contents and limitations contained herein shall satisfy this requirement when transactions occur telephonically. An informational screen containing these limitations with an affirmative acknowledgement by the consumer, prior to application, shall satisfy this requirement for internet transactions.

MINIMUM PHYSICAL DAMAGE INSURANCE IS REQUIRED FOR THE FULL TERM OF THE INSTALLMENT CONTRACT to protect all interests thereunder against collision, fire, theft and the additional hazards covered by Combined Additional Coverage. YOU MAY CHOOSE THE PERSON THROUGH WHICH ANY OF THIS INSURANCE IS OBTAINED.

FAIR CREDIT REPORTING ACT DISCLOSURE

I/We understand that this application for credit will be submitted by the Dealer to various financial institutions for evaluation.

Be sure to check your Credit Application for completeness and accuracy before submitting. Once submitted, you will not be able to return to make changes.

Required Acceptance *

Credit Application

CREDIT APPLICATION

Applicant Information

Please complete the form below and click the "Agree" button.

Applicant Employment

Co-Applicant Information

Co-Applicant Employment

Authorization

Please read this information carefully and print a copy and/or retain this information electronically for future reference.

AutoSelect

Reliable Cars & Trucks

Auto
Select