Submit a Credit Application to the Loop East Motor Company

LOOP EAST MOTOR COMPANY		ONLINE CREDIT APPLICATION
This Online Credit Application is located on a Secure Server. Your information that you submit through this form will be used only by the Loop East Motor Company for the Vehicle Loan approval process. Information is never shared or distributed to any person outside the Loop East Motor Company.
IMPORTANT: Read these Directions before completing this Application. (Check Appropriate Box)
	If you are applying for Individual credit in your own name and are relying on your own income or assests and not the income or assets of another person as the basis of repayment of the credit requested, do not complete the sections relating to joint applicant.
	If this is an application for joint credit with another person, complete all sections, providing information about the joint applicant.
	If you are applying for individual credit, but are relying on income from alimony, child support, or separate maintenance or on the income or assets of another person as the basis for repayment of the credit requested, complete all sections to the extent possible, providing information about the person on whose alimony, support, or maintenance payments or income or assets you are relying.
Applicant Name			BirthDate
Address		City/State	Zip Code
No. Years	Phone	Social Security Number	Drivers License Number
Employer	Phone	Length of Employment	Position

Joint Applicant			BirthDate
Address		City/State	Zip Code
No. Years	Phone	Social Security Number	Drivers License Number
Employer	Phone	Length of Employment	Position

Former/Present Bank		Account Number(s)
Name of Friend or Relative			Phone
Name of Friend or Relative			Phone

Purpose of Loan			Amount Requested

INCOME You do not have to reveal income from alimony, child support, or separate maintenance unless you wish to have it considered as basis for repayment.
Applicant Income	Per	Other Income	Per
Joint Applicant Income	Per	Other Income	Per

MORTGAGE OR RENT
Payment Amount	To Whom
Purchase Price	Balance	Value

PROPERTY-AUTO/TRUCKS DESCRIPTION	IS IT FINANCED?	CREDITOR	BALANCE/LOAN PAYMENTS
	Yes No
	Yes No
OTHER DEBTS-CREDITOR		AMOUNT	PAYMENT
OTHER DEBTS-CREDITOR		AMOUNT	PAYMENT

Everything that I have stated in this application is correct to the best of my knowledge. I understand that you will retain this application whether or not it is approved. Loop East Motor Company is authorized to check my credit and employment history and I will answer questions about my credit history with Loop East Motor Company.
Applicant Name		Applicant Email Address

Please look over the information you entered above and make sure it is correct. When complete, please click the 'Submit Application' button below to send your credit application to the Loop East Motor Company.