Credit Application

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* Required Field

Application Type *

Personal Information

Applicant:

First Name *

Middle Name/Initial

Last Name *

Email Address *

Cell Phone *

Social Security #*

Date of Birth *

Driver's License # *

Driver's License Exp. Date *

Driver's License Issued In

Co-Applicant

First Name *

Middle Initial

Last Name *

Email Address *

Cell Phone *

Social Security # *

Date of Birth *

Driver's License # *

Driver's License Exp. Date *

Driver's License Issued In

Employment Information

Applicant:

Employment Status *

Current Employer *

Title / Occupation *

Employer Address *

Employer Address Line 2

City *

State*

Zip Code *

Business Phone *

Time at Employer - Years *

Time at Employer - Months *

Gross Monthly Income *

Previous Employer *

Title / Occupation *

Time at Employer - Years *

Time at Employer - Months *

Co-Applicant

Employment Status

Current Employer *

Title / Occupation *

Employer Address *

Employer Address Line 2

City *

State*

Zip Code *

Business Phone *

Time at Employer - Years *

Time at Employer - Months *

Gross Monthly Income *

Previous Employer *

Title / Occupation *

Time at Employer - Years *

Time at Employer - Months *

Residential Information

Applicant:

Current Address *

Current Address Line 2

City *

County *

State*

Zip Code *

Status *

Mortgage Payment / Rent *

Time at Residence - Years *

Time at Residence - Months *

Previous Address

Previous Address Line 2

City

County

State

Zip Code

Status

Mortgage Payment / Rent

Time at Residence - Years

Time at Residence - Months

Co-Applicant

Current Address *

Current Address Line 2

City *

County *

State*

Zip Code *

Status *

Mortgage Payment / Rent *

Time at Residence - Years *

Time at Residence - Months *

Previous Address

Previous Address Line 2

City

State

Zip Code

Status

Mortgage Payment / Rent

Time at Residence - Years

Time at Residence - Months

Financial Information

Applicant:

Mortgage Balance

Mortgage Lender

Monthly Payment

Name of Bank

Account Type(s)

Name of Bank

Account Type(s)

Other Income (monthly)

Source

Other Income (monthly)

Source

Other Income (monthly)

Source

Desired Vehicle

Filter Desired Vehicle

Year:

Make:

Model:

Reset Filter

Desired Vehicle

Downpayment

Comments, References or Additional Information

I certify that the information provided by me is correct.
I certify that I am eighteen years of age or older.

I also understand that you will be checking with credit reporting agencies.
I authorize an investigation of my credit and employment history and the release of information about my credit experience.

Dealership Info

Contact Us

Main Phone:

503-841-6360

Fax:

971-254-8675

Email:

vdautomall@yahoo.com

Business Hours

Mon:	9:00am-6:00pm
Tue:	9:00am-6:00pm
Wed:	9:00am-6:00pm
Thu:	9:00am-6:00pm
Fri:	9:00am-6:00pm
Sat:	10:00am-5:00pm
Sun:	CLOSED

Location

5210 NE Columbia BLVD
Portland, OR 97218

Credit Application

Credit Application

Personal Information

Applicant:

Co-Applicant

Employment Information

Applicant:

Co-Applicant

Residential Information

Applicant:

Co-Applicant

Financial Information

Applicant:

Co-Applicant

Desired Vehicle

Downpayment

Dealership Info

Contact Us

Business Hours

Location

Dealership Map