Baladi Auto Center Credit Application

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PERSONAL INFORMATION    
First Name:  
Middle Name:
Last Name:  
Birth Date:
SSN:  
Email Address:  
Street Number:  
Street Name: Apt. #:
   
City , State ZipCode: ,      
      
How Long?   (Years)    (Months)  
 
Residence Owned By:  
Monthly Payment: ($)
Landlord / Mortgage Co.:
Landlord Phone:  
Home Phone:  
Mobile Phone:  
Work Phone Number: x  
Other Phone Number:  
Checking Bank Name:
Savings Bank Name:
Direct Deposit Bank:
Nearest Living Relative:
Relative's Address:
City , State ZipCode: ,      
Phone Number:  

DOWN PAYMENT
Down Payment Amount: ($)
Trade-In Payoff: ($)

EMPLOYMENT INFORMATION
Employment Status:  
Current Employers Name:
Employer's Address:
City , State ZipCode: ,      
Job Title:
Name of Supervisor:
Phone of Employer/Supervisor:  
Time On the Job:  (Years)    (Months)  
 
***Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.***
Monthly Gross Income: ($)
Other Income: ($)
Other Income Source:
Other Income Phone:  

ADDITIONAL INFORMATION
If at current address for less than two years:
Previous Address:
City , State Zipcode:   ,      
How Long?  (Years)    (Months)  
 
If at current employer less than two years:
Previous Employer's Name:
Time On the Job:  (Years)    (Months)
 
Comments:


I authorize AutoClick to submit my application to a Seller and/or Finance Source(s) for review in connection with the assignment of a sales finance contract written, or to be written, in connection with my purchase of a motor vehicle. I certify that the above information is complete and accurate. In connection with this application, I authorize and give AutoClick, Seller and any Finance Source that reviews my application my consent to obtain my consumer report from any consumer reporting agency and complete an investigation of my credit and employment history and release information about my credit experience with Seller and/or Finance Sources. After my executed contract is assigned to a Finance Source, I also authorize and give consent to the assigned Finance Source to obtain my consumer report from any consumer reporting agency at any time during the term of my contract for any purpose whatsoever, including but not limited to for prescreening, as defined and permitted from time to time by the Consumer Financial Protection Bureau; for reviewing my contract; to defer or extend my payments or due date under my contract; to take collection action on my contract; or for other legitimate purposes associated with my contract for which there is a permissible purpose under the federal Fair Credit Reporting Act. I understand and acknowledge that AutoClick, Seller and any Finance Sources who review this application will retain this application whether or not it is approved. I also understand and acknowledge that, to the extent required by applicable law and in accordance with the same, I will be informed if a consumer report was requested in connection with this application for credit, and the name and address of the consumer reporting agency that furnished the report.

By checking the box below on this application I authorize and give my express consent to Seller and its Finance Sources to use the email address and telephone numbers (either landlines or wireless) I have provided on this application or which Seller or its Finance Sources obtains in any manner to communicate with me for any purpose whatsoever, including but not limited to communication regarding my account activity, status and to collect any debt obligation I owe to a Finance Source. You agree that if an account is created for you, all of the following will also apply: (a) Seller and/or its Finance Source(s) may monitor and record telephone calls regarding your account to assure the quality of our service or for other reasons; (b) you expressly consent to Seller and/or its Finance Source(s) using prerecorded/artificial voice messages, text messages and/or automatic dialing equipment while servicing or collecting your account, as the law allows; (c) you agree that Seller and/or its Finance Source(s) may take these actions using the telephone number(s) that you provide in this credit application, you provide in the future, or Seller and/or Finance Source get from another source, even if the number is for a mobile telephone and/or our using the number results in charges to you.


STATE LAW DISCLOSURES – PLEASE READ

CA Applicants: IF MARRIED YOU MAY APPLY FOR CREDIT SEPARATELY AS AN INDIVIDUAL.

ME Applicants: You must have physical damage insurance covering loss or damage to the vehicle for the term of any contract. For a lease, you must also have the liability insurance as described in the lease. You may buy this insurance from anyone you choose. You do not have to buy it from someone affiliated with the dealer or an assignee of the contract you enter into. Your choice of insurance will not affect the credit approval process unless the insurance does not satisfy the contract requirements or the insurance company does not satisfy the reasonable standards of the dealer or an assignee of the contract you enter into.

NH Residents: If you are applying for a balloon payment contract, you are entitled, it you ask, to receive a written estimate of the monthly payment amount for refinancing the balloon payment in accord with the creditor's existing refinance programs. You would be entitled to receive the estimate before you enter into a balloon payment contract. A balloon contract is air installment sale contract with a final scheduled payment that is at least twice the amount of one of the earlier scheduled equal periodic installment payments.

NY Applicants: Consumer reports may be requested in connection with this application. Upon request, you will be informed whether or not a consumer report was requested and, if it was, of the name and address of the consumer reporting agency that furnished the report. Additional consumer reports may be requested with respect to any extension or renewal of this obligation.

OH Applicants: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

RI Residents: Consumer reports may be requested in connection with this application.

VT Residents: If an account is created, you authorize the obtaining of credit reports for purposes of reviewing or taking collection action on the account or for other legitimate purposes associated with the account.

Notice to Married WI Residents: No provision of any marital property agreement, a unilateral statement under Wis. Stat. § 766.59 or a court decree under Wis. Stat. §766.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the creditor is incurred. The credit being applied for, if granted, will be incurred in the interest of my marriage or family. I understand that the creditor may be required by law to give notice of the credit transaction to my spouse.

By clicking submit, I certify that the information provided by me is complete, true and accurate. I also authorize you and any party evaluating this application (collectively, 'Creditors') to obtain my consumer reports from one or more credit reporting agencies.



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