Adel Motors (Application For Financing)  

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  1. Either, fill in the boxes below and submit online
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Applicant First Name: Last Name: MI:

Residence Address
Street Name: Street Number:   City: State: Zip:

Previous Address if less than 2 years
Street: City: State: Zip:

Landlord or Mortgage Holder
  Buy Rent Other

Mortgage or Rent Payment: Mo.

Purchase Price of Property:

Estimated Home Value:

Mortgage Balance:

Employer Name:

Employer Address:

Occupation:

How Long?
Yrs      Mos

Work Phone No:

Monthly Income from Employer:
Gross: $ Net: $

Previous Employer Name:

How Long?
Yrs Mos

All other monthly income:
Gross: $ Net: $

Source of other income:

Total Monthly Income:
Gross: $ Net: $

Other Income: (Read to applicant: "Income from alimony, child support, or separate maintenance payments need not be revealed if you do not choose to rely on such income in applying for credit.")

Has the applicant taken bankruptcy with the last 7 years?
No Yes (if "yes," indicate year taken)

Bank Reference:
Name: Address:

Checking Loan
Saving Other

Personal Reference (Relative or Friend)
Name:

Address:

Phone No:

Co-Applicant:
First Name: Last Name: MI:
Residence Address
Street: City: State: Zip:

Previous Address if less than 2 years
Street: City: State: Zip:

Buy Rent Other
Landlord or Mortgage Holder

Mortgage or Rent Payment:
$ /Mo.

Purchase Price of Property:
$ Mo.

Estimated Home Value:
$ Mo.

Mortgage Balance:
$

Employer Name and Address:

Occupation:

How Long?
Yrs Mos

Work Phone No

Monthly Income from Employer
Gross: $ Net: $

Previous Employer

How Long?
Yrs Mos

All other monthly income
Gross: $ Net: $

Source of other income:

Total Monthly Income
Gross: $ Net: $

Other Income: (Read to applicant: "Income from alimony, child support, or separate maintenance payments need not be revealed if you do not choose to rely on such income in applying for credit.")

Has the applicant taken bankruptcy with the last 7 years?
No Yes (if "yes," indicate year taken)

Bank Reference:
Name: Address:

Checking Loan
Saving Other

Personal Reference (Relative or Friend)
Name:

Address:

Phone No:

I authorize the seller and its assignee to make whatever inquiries it deems necessary in connection with this credit application and in the course of it review or collection of any credit extended in reliance on this application. I further authorize any person or consumer reporting agency to complete and furnish to the seller and its assignee any information that it may have or obtain in response to such inquiries, and agree that such information, along with this application shall remain the sellers and its assignee's property, whether or not credit is extended. All information stated in this application is declared to be a true representation to the facts and is made for the purpose of obtaining the credit requested.

Valid Visa Carte Blanche Dept. Store
Credit Master Card American Express
Card Discover  Diner's Club Acct. No.: Exp. Date:

Owner's License No and or State ID No:

Other Qualifying ID:

Dealer's Name:
Fax No:

Applicant's Signature:

____________________________________ Date: ________

Dealer's Location:
Phone No:

Co-Applicant's Signature:

_______________________________ Date: _______