Credit Application

Credit App

Credit Application for SMG Auto Brokers

"*" indicates required fields

Personal Information

Personal or Business*

Full Legal Name

Please type your full name as it appears on your Driver's License

First Middle Last

Company Name*

Company Name

Birth Date*

Date of Inception*

Driver License Number*

Driver License Issue State*

Social Security Number*

Employer Identification Number (EIN)*

Phone*

Cell phone is preferred.

Email*

Please use the *same email* you've used with us previously.

Address*

Street Address City State ZIP Code

Years at Current Address

How many years in operation*

Nature of business*

Since less than 5, please provide previous address for last 5 years

Street Address Address Line 2 City State ZIP Code

Employment Information

Occupation / Title*

Present Employer (Company Name)*

How long at this employer?*

Employer Phone Number*

Employer's Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Previous Employment of History (5 years)

Please enter the employer names and phone numbers to cover the past 5 years.

Total Monthly Income (Gross)*

Please make sure you are inputting your total MONTHLY income and not yearly.

Marital Status*

Do you Own or Rent?*

Monthly Mortgage or Rent Payment*

Do You Have a Co-Signer?

Yes

Co-Signer's Full Legal Name*

Co-Signer's Relation

Co-Signer's Birth Date*

Co-Signer Driver License Number*

Co-Signer's Social Security Number*

Co-Signer Email*

Co-Signer Phone*

Co-Signer Address*

Street Address Address Line 2 City State ZIP Code

Co-Signer Years At Current Address?*

Co-Signer Previous Addresses

Street Address Address Line 2 City State ZIP Code

Since years at current address less than 5, please enter a previous address for your co-signer.

Co-Signer Occupation / Title*

Co-Signer Current Employer*

Co-Signer Years at Employer*

Co-Signer's Employer's Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Co-Signer Work Phone Number

Co-Signer Previous Employment (5 Years)

Since your co-signer has less than 5 years at current employer, please provide the name, address, and phone for previous employers covering the last 5 yeras.

Co-Signer Total Monthly Income (Gross)*

Co-Signer Own or Rent*

Co-Signer Monthly Mortgage or Rent Amount*

Signature*

(by signing this, you are allowing access to your credit report)

Co-Signer Signature*

(by signing this, you are allowing access to your credit report)

Fair Credit Reporting Act Disclosure

By Signing this document you agree to the following: I certify that the information I have provided on this application is , to the best of my knowledge, complete and accurate. I have read the Privacy Policy and authorize that my credit report be obtained. I am 18 years of age or older with a valid drivers license. I understand that financial institution(s) will rely on this information to judge my credit worthiness, and will retain this application and information about me whether or not this application is approved. Further, I authorize an investigation of my credit and employment history, in conjunction with which my credit report(s) may be obtained from one or more consumer credit reporting agencies. I understand that false statements may subject me to criminal penalties. I further understand that the Dealer and/or the financial institution(s) that evaluate my application may require additional information. I/We understand that this application for credit will be submitted by the dealer to various financial institutions for evaluation.

This field is for validation purposes and should be left unchanged.

Credit App

Personal Information

Employment Information

Fair Credit Reporting Act Disclosure

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