Kastner Honda - CREDIT APPLICATION

Credit Application

You can rest assured we will strive to meet and exceed your needs. We are dedicated to ensuring that your experience with us is nothing short of superb. Use the form below to apply for credit:

Those fields in red must be filled in to process the application.

PERSONAL INFORMATION
First Name:
M. Initial:
Last Name:
Suffix:
Email Address:
Home Phone:
Work Phone:
Cell Phone:
The best way to contact you:	Home Phone Work Phone Cell Phone Email Address
Date of Birth:
Social Security #:
Marital Status:
Number of Dependents:

ADDRESS INFORMATION
	Current Address
Address:
City:
State:
Zip:
Do you Rent or Own:
Monthly Rent/Mortgage $:
How long have you stayed here?:	Years Months

	Previous Address (If less than 5 years at current address)
Address:
City:
State:
Zip:
How long did you stay there?:	Years Months

EMPLOYMENT INFORMATION
	Current Employer
Work Status:
Company:
Job Title:
Address:
City:
State:
Zip:
Monthly Gross Income $:	(Before Taxes)
How long on this job?:	Years Months

	Previous Employer (If less than 5 years at current job)
Company:
Job Title:
Address:
City:
State:
Zip:
How long on that job?:	Years Months

FINANCIAL INFORMATION
Credit History:
Bank/Credit Union Name:
Phone Number:
Account Number:
Account Type:

	Other Income / Expenses
Alimony, Child Support, Separate Maintenance, Settlement
If you are obligated to any of these payments, enter total amount.
$:
If you receive any of these payments, enter total amount.
$:

VEHICLE INTERESTED IN
Year:
Make:
Model:
Purchase Time:

TRADE-IN VEHICLE
Year:
Make:
Model:
Mileage:

COMMENTS and/or QUESTIONS

Please review the information you have provided. If all of it is accurate, press the submit button.

By submitting this form, you certify that the information provided is complete and accurate to the best of your knowledge. Creditors receiving this application will retain the application whether or not it is approved. Creditors may rely on this application in deciding whether to grant the requested credit. False statements may subject you to criminal penalties. You authorize the creditors to obtain credit reports about you on an ongoing basis during this credit transaction and to check your credit and employment history on an ongoing basis during the term of the credit transaction. If this application is approved, you authorize the creditor to give credit information about you to its affiliates.