Quick
Credit Application
Full
Name:
_________________________
Email:
___________________
D.O.B:
_______________
Social Security #:
_________________
Home
Phone:
_________________
Work/Cell Phone:
__________________
Current
Address:
_____________________________Years
There:
_____
City:
_________________________
State:
_________
Zip:
____________
Rent/ Monthly
Mortgage Payment__________ Real Estate Value:
_____________
Employer:
____________________Position: _____________ Years There:
______
Monthly
Income:
________________
Vehicle Year:
_________Make: _______________ Model: ______________
Selling
Price: __________________ Loan Amount:
___________________
I/WE HAVE READ THIS
APPLICATION AND CERTIFY THAT EVERYTHING I/WE HAVE STATED
IS ACCURATE. JJ BEST BANC & CO. MAY PROVIDE SUCH
INFORMATION SET FORTH IN THE APPLICATION AND ANY OTHER
INFORMATION WE RECEIVE TO ANOTHER CREDITOR FOR
CONSIDERATION. BY SUBMITTING THIS APPLICATION FORM, I/WE
GIVE JJ BEST BANC & CO., ITS CORPORATE AFFILIATES, OR
ITS ASSIGNS, THE AUTHORIZATION TO ACCESS MY CREDIT
REPORTS, EMPLOYMENT HISTORY, OR ANY OTHER INFORMATION
SOURCES. I/WE UNDERSTAND THAT THE INFORMATION I/WE HAVE
PROVIDED IS GIVEN TO OBTAIN CREDIT FROM JJ BEST BANC &
CO. OR ITS ASSIGNEES, AND THAT JJ BEST BANC & CO. WILL
RETAIN THIS APPLICATION WHETHER OR NOT IT IS APPROVED,
EXCEPT AS OTHERWISE PROHIBITED BY APPLICATION LAW OR
REGULATION. JJ BEST BANC & CO. WILL KEEP YOUR FINANCIAL
INFORMATION CONFIDENTIALLY. THIS OFFER IS AVAILABLE FOR
SALES IN THE U.S. ONLY. THIS APPLICATION IS SUBJECT TO
THE COMPLETION AND ACCEPTANCE OF ADDITIONAL CREDIT
APPLICATION DOCUMENTS PRIOR TO ANY APPROVAL EXTENSION OF
CREDIT. MARRIED APPLICANTS MAY APPLY FOR AN INDIVIDUAL
ACCOUNT. LAW PROHIBITS DISCRIMINATION ON THE BASIS OF
MARITAL STATUS OR SEXUAL ORIENTATION. IF AT ANY TIME
REVIEWING YOUR CREDIT BUREAU REPORT, YOU BELIEVE THAT JJ
BEST BANC & CO. HAS REPORTED SOMETHING REGARDING YOUR
ACCOUNT IN ERROR, YOU MUST CONTACT US 1 800 872-1965 TO
REGISTER YOUR DISPUTE. YOU MAY ALSO FILE YOUR DISPUTE
DIRECTLY THROUGH THE APPLICABLE CREDIT REPORTING AGENCY.
Signature:
X____________________________________________________
Dealer:
ญญญ__________________________________ Phone #:
_________________
Please fax to 508-991-8329
ATTENTION : MELISSA