Cross Country Auto Sales| Albuquerque, NM, area car, truck and SUV dealer

* First Name:

* Last Name:

Middle Initial:

* Date of Birth:
(mm/dd/yyyy)

* SSN#:

* Current Address:

* City:

* State:

* Zip:

* Phone:

* Email:

* Time at address:

Previous address if less than 2 years at current:

Time at previous address:

* Current Employer:

* Employer's Address

* Work Phone:

* Applicant's Occupation

* Time at Current Job:

* Gross Salary (before taxes):

Previous employer if less than 2 years at current:

Time at previous employer:

Other Income:

Source of other income:

* Have you ever financed a vehicle:

yes

no

* Do you have a trade in, if yes what is it:

What is the payoff:

* Have you ever had a car or other merchandise repossessed:

Yes

No

* Have you ever filed bankruptcy:

Yes

No

* Name of Bank/Credit Union:

* Type of account(s):

Check & Savings

Checking Only

Savings Only

No Account

* I have read the Privacy Statement and fully understand its terms.

Yes

No

* By submitting this credit application, I hereby authorize Cross Country Auto Sales, LLC to perform a credit check, which includes pulling statements from Credit Bureau(s) and other credit reporting agencies.

Yes

No