Have you previously purchased a new or used vehicle from Zimmerman Cars?
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INSTRUCTIONS:
You may apply for credit in your name alone, whether or not you are married.
(1) Please indicate whether you are applying
Individually, or With another person
(2) Indicate you marital status here only if:
a) you live in a community property state (AZ, CA, ID, LA, NM, MV, TX, WA, WI), or
b) this is a joint application, or
c) this is an application for secured credit.
MARRIED UNMARRIED SEPARATED
(3) If you are applying for credit with anther person, please complete all sections.
(4) If you are married and live in a community property state, or any property that will secure this credit is located within a community property state, please provide information about you spouse in the "Co-Applicant" section (even if this application is in your name alone)
Will Applicant(s) be principal driver/operator? Yes No
The vehicle being applied for will be used primarily for: (check one)
Personal, family, or household use.
Business, commercial, or agricultural purposes, or you are an organization or governmental entity.
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| Applicant Information |
* = Required Information |
| * First Name: |
| Middle Name: |
| * Last Name: |
| * Date of Birth: |
| * Social Security No. |
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* Driver's License No.
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| * Phone (day): ()- |
Cell: ()- |
| Phone (eve): ()- |
Fax: ()- |
| * Email: |
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* Contact Me By:
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Housing Information |
| * Address: |
* City: |
| * State: |
* Zip: |
| I Own My Residence |
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Mortgage Institution's Name:
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Mortgage Institution's Address:
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Mortgage Institution's City:
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Mortgage Institution's State:
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Mortgage Payment Amount:
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$ |
| I Rent My Residence |
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Landlord's Name:
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Landlord's Address:
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Landlord's City:
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Landlord's State:
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Monthly Rent Payment:
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$ |
| Buying Parents Other
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* Years at Current Residence: |
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(If less than 3 years at current residence)
Years at Previous Residence:
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Previous Address:
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Previous Address City:
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Previous Address State:
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Employment Information |
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* Employer Name:
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* Job Title:
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(as appears on Employer's Records) |
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* Length of Employment:
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Income Information |
| * Gross Yearly Income: |
| Other Income: |
Source of Other Income:
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| Nearest relative not living with you: |
| Name: |
| Address: |
City: |
| State: |
Zip: |
| Phone: ()- |
Relationship to Applicant:
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| Please Provide Two References |
| Reference #1 |
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| Name: |
| Address: |
City: |
| State: |
Zip: |
| Phone: ()- |
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| Reference #2 |
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| Name: |
| Address: |
City: |
| State: |
Zip: |
| Phone: ()- |
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Comments:
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 Note: All information will be sent through a Secure Server Connection.
Zimmerman Honda keeps the personal information submitted with your request
for pre-approved credit private and confidential.
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