Employment information
Company:___________________________________________________________________________
Address:____________________________________________________________________________
City/State: ________________________________________________ Zip Code:_________________
Phone#:_________________________________________________ Years Employed:____________
Supervisor:_______________________________________________ Hours of Work:______________
Personal references ( Three required )
1 ) Name:___________________________________________________________________________
Address:____________________________________________________________________________
City/State: ________________________________________________ Zip Code:_________________
Phone#:_________________________________________________ Relation:___________________
2 ) Name:___________________________________________________________________________
Address:___________________________________________________________________________
City/State: ________________________________________________ Zip Code:_________________
Phone#:_________________________________________________ Relation:___________________
3 ) Name:___________________________________________________________________________
Address:___________________________________________________________________________
City/State: ________________________________________________ Zip Code:_________________
Phone# :_________________________________________________ Relation:___________________
Spouse or Co-Signer
Name:______________________________________________________________________________
Address:____________________________________________________________________________
City/State: ________________________________________________ Zip Code:_________________
SS#: ___________________________________________________
Date of Birth:________________
Phone#:_________________________________________________ Years at Address:____________
Place of Employment
:________________________________________________________________
Address of Employment
:______________________________________________________________
City & State of Employment
:___________________________________________________________
Phone # of Employment
:______________________________________________________________
Are You Currently Financing a Car?
Yes
No
If Yes, Balance Owed : $_______________________________________
Name of Dealership :__________________________________________
Any Current Insurance or Parking Violations at MVA?
Yes No
Is Your Maryland Drivers License Currently Suspended?
Yes No
Under Contract with Classic Used Cars and Leasing Company
Incorporated, I, the Purchaser, Understand that upon Default of My Contract, I
do give Classic Used Cars and Leasing Company Incorporated Permission to get a
Credit Report from any Credit Bureau.