STEP 1: BASIC INFORMATION

CREDIT APPLICATION

Soc Sec #

Date of Birth

First Name

MI

Last Name

Street Address

Apartment/Suite

City

State

ZIP

Primary Phone #:

Work Phone #:

Select One

Email

STEP 2: RESIDENCE INFORMATION

Who Owns Your Home?

STEP 3: INCOME INFORMATION

(Month / Year)

Move in Date:

Landlord: Name:

       Phone:

Total Down Payment Today:

What Account Type Do You Have?:

Bank Name:

Income Type: (Choose One Below)

(mm/dd/yyyy)

Gross Monthly Pay:

Start Date (Hire Date):

Employer:

Employer Phone:

Any Additional Income:

I acknowledge that pursuant to the Fair Credit Reporting Act, my application will be submitted to financing sources for review in connection with the assignment of a sales finance contract written, or to be written, in connection with my purchase. I certify that the above information is complete and accurate, in connection with this application, authorize and give Seller and any finance companies determined by Seller consent to obtain my credit report from any Credit Reporting Agency and complete an investigation of my credit and employment history and release information about my credit experience with seller and for any finance company and after my contract is assigned to any finance company. I also authorize and give consent to any finance company to obtain my credit report from any Credit Reporting Agency at any time during the term of my contract. for reasons including but not limited to pre screening, as defined and permitted from time to time by the Federal Trade Commission; for reviewing my contract; to defer or extend my payments or due date under my contract; to take collection action on my contract; or for other legitimate purposes associated with my contract. I understand and acknowledge that any finance company will retain this application whether or not it is approved. I also understand and acknowledge that if I ask, I will be informed if a credit report has been requested in connection with this application for credit, and the name and address of the Credit Reporting Agency that furnished the report. "Email and Cellular Communication Consent: By signing below I authorize and give consent to any finance company to use the email address and cellular telephone numbers I have provided on this application or which Credit Acceptance obtains to communicate with me for purposes including but not limited to communication regarding my account activity, status and to collect any debt obligation I owe to any finance company. This authorization includes consent for any finance company to make calls to any of my current or future cellular telephone numbers using any automatic telephone dialing systems or artificial or prerecorded voice. Spousal Consent: By signing below I authorize and give consent to any finance company to discuss my account with my spouse, if applicable, including discussing my account activity status and payment arrangements.

Signature of Application/Joint Applicant

(Type name/names to sign)

Date

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Opening Hours

Mon - Fri: 7:30am - 5:30pm

Sat: 8am - 12pm

Sun: Closed

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1501 Huntsville Highway

Fayetteville, TN 37334

United States

Tel:1(931)297-2266

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