4020 S. Broadway Wichita, KS 67216
"Good transportation, reasonably priced"
(316) 522-3491
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Credit Application


* Required Information
Application Information
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* First Name:
Middle Name:
* Last Name:
* Date of Birth: (mm/dd/yyyy)
* Social Security Number:
* Email:
* Home Phone:
Work Phone:
Cell Phone:
Address:
City:
State:
Zip:
Do you own, rent, or live with family?
How Long at Address:
If you own or rent, how much are your monthly payments?
Previous Address:
City:
State:
Zip:
How Long at Address:
Employment Information
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Employer:
Gross Annual Income:
Address:
City:
State:
Zip:
Occupation:
How Long at Company:
Previous Employer:
Address:
Years:
Occupation:
How Long at Company:
Previous Employer:
Address:
Years:
Occupation:
How Long at Company:
Contact Information
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Please use the options to the right to schedule an appointment.
Best time to call:
Appointment Desired:
Set Appointment:
Appointment Time:
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Please submit two seperate credit applications when a cosigner is submitting their credit information. Please use the comments box below to also inform us of any additional information, including cosigner information.
Additional Comments:
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* In order for us to provide you with a painless buying experience, we'll need your social security number to run a credit check. If you proceed with the questions above and submit your information above by clicking on the 'submit' button, you are thereby giving your consent for our dealership to obtain a consumer credit report.

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