Rustys Auto Sales
Secure Loan Application
Primary Borrower Information
Loan Information
Desired Loan Amount:
Desired Monthly Payment:
Personal
First Name:
Middle Initial:
Last Name:
Address:
City:
State:
--Select State--
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
DC
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI
MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
US Virgin Islands
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
Zip:
Daytime Phone:
Evening Phone:
Fax:
-
-
Email:
Social Security Number:
-
-
Birthday:
--Month--
January
February
March
April
May
June
July
August
September
October
November
December
/
--Day--
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
--Years--
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
Mortgage/Rent Payment:
per month
Residence Type:
--Select--
Own Home with Mortgage
Own Home without Mortgage
Rent
Live with Relative
Other
Time at Residence:
Years
Time at Residence:
Months
If you have lived at your current residence less than 5 years, please enter your prior address:
Which accounts are in your name:
Utilities
Savings
Checking
Phone
Drivers Lic. #:
Drivers Lic. State:
(CA,NY, etc.)
Driver Lic. Exp. Date:
(MM/DD/YYYY)
Employment
Employer Name:
Employer Address:
Employer City:
Employer State:
--Select State--
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
DC
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI
MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
US Virgin Islands
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
Employer Zip:
Business Phone:
Occupation:
Employment Status:
--Select--
Full Time
Part Time
Retired
Military
Self-Employed
Contract
Seasonal
Temporary
Unemployed
Time On Job:
Years
Time On Job:
Months
How often are you paid:
--Select--
Weekly
Bi-Weekly
Monthly
Yearly
How much per paycheck:
(numbers only)
Other Income:
per month
I accept these terms.
I agree that by submitting this application, I authorize and give this dealership, as well as any potential financing source this dealership presents this application to, my consent to obtain my credit report from any credit reporting agency used to complete an investigation of my credit.
By submitting this application, I certify that all information herein is true and complete. I agree I am providing this information to the dealer identified in this application and acknowledge that my information may be shared pursuant to the dealer's privacy policy, if applicable. I hereby authorize this dealer, and any financial institution engaged as a service provider by this dealer, to retain this application and to check and verify my credit, employment and salary history. By submitting this application, I authorize this dealer and/or financial institutions, as they consider necessary and appropriate, to obtain consumer credit reports on me periodically and to gather employment history in order to determine financing eligibility.
Vehicle Information
Vehicle Make:
Vehicle Model:
Vehicle Year:
Vehicle Mileage:
Down Payment
Down Payment Amount:
Trade-In Details
Trade-in Make:
Trade-in Model:
Trade-in Year:
Trade-in Mileage:
Additional Comments:
Add Co-Borrower
Co-borrower Information
Personal
First Name:
Middle Initial:
Last Name:
Address:
City:
State:
--Select State--
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
DC
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI
MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
US Virgin Islands
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
Zip:
Daytime Phone:
Evening Phone:
Fax:
-
-
Email:
Social Security Number:
-
-
Birthday:
--Month--
January
February
March
April
May
June
July
August
September
October
November
December
/
--Day--
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
--Years--
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
Mortgage/Rent Payment:
per month
Residence Type:
--Select--
Own Home with Mortgage
Own Home without Mortgage
Rent
Live with Relative
Other
Time at Residence:
Years
Time at Residence:
Months
If you have lived at your current residence less than 5 years, please enter your prior address:
Which accounts are in your name:
Utilities
Savings
Checking
Phone
Drivers Lic. #:
Drivers Lic. State:
(CA,NY, etc.)
Driver Lic. Exp. Date:
(MM/DD/YYYY)
Employment
Employer Name:
Employer Address:
Employer City:
Employer State:
--Select State--
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
DC
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI
MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
US Virgin Islands
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
Employer Zip:
Business Phone:
Occupation:
Employment Status:
--Select--
Full Time
Part Time
Retired
Military
Self-Employed
Contract
Seasonal
Temporary
Unemployed
Time On Job:
Years
Time On Job:
Months
How often are you paid:
--Select--
Weekly
Bi-Weekly
Monthly
Yearly
How much per paycheck:
(numbers only)
Other Income:
per month
I accept these terms.
I agree that by submitting this application, I authorize and give this dealership, as well as any potential financing source this dealership presents this application to, my consent to obtain my credit report from any credit reporting agency used to complete an investigation of my credit.
By submitting this application, I certify that all information herein is true and complete. I agree I am providing this information to the dealer identified in this application and acknowledge that my information may be shared pursuant to the dealer's privacy policy, if applicable. I hereby authorize this dealer, and any financial institution engaged as a service provider by this dealer, to retain this application and to check and verify my credit, employment and salary history. By submitting this application, I authorize this dealer and/or financial institutions, as they consider necessary and appropriate, to obtain consumer credit reports on me periodically and to gather employment history in order to determine financing eligibility.
Add Another Co-Borrower
Submit Application
Submit Co-Borrower Application