Apply for CreditPlease fill out the Credit Application Below Limo Land 1903 N. Barnes Avenue Springfield, MO. 65803 Ph# 417-866-6565 Fax #417-866-6142 Business Information Legal Business Name * First Name Last Name President/Owner Name * First Name Last Name Email * Street Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone # * (###) ### #### Fax # (###) ### #### Date of Incorporation MM DD YYYY State of Incorporation Federal Tax ID # Business Start Date MM DD YYYY Type of Business * Please select Corporation Partnership Proprietor Website Address http:// Current Fleet Size Company Principals/Guarantor Signature Information Name * First Name Last Name Title % of Ownership Home Address Address 1 Address 2 City State/Province Zip/Postal Code Country Social Security Number Home Phone (###) ### #### Cell Phone (###) ### #### Date of Birth * MM DD YYYY Email Address Time at Residence Residence Type Please select below Own Rent Additional Income Please place amount of additional income below ex: $3,000 monthly, or $36,000 yearly Source of Income Additional Owner(s) Information Name First Name Last Name Title % of Ownership Home Address Address 1 Address 2 City State/Province Zip/Postal Code Country Social Security Number Home Phone (###) ### #### Cell Phone (###) ### #### Date of Birth MM DD YYYY Email Address Time at Residence REsidence Type Please Select Below Rent Own Additional Income Please place amount of additional income below ex: $3,000 monthly, or $36,000 yearly Source of Other Income Comparable Borrowing Reference Vehicle 1 Where Financed Type of Vehicle Lender Phone Number (###) ### #### Vehicle 2 Where Financed Type of Vehicle Lender Phone Number (###) ### #### Vehicle 3 Where Financed Type of Vehicle Lender Phone Number (###) ### #### Business Bank Information Bank Name * Bank Contact First Name Last Name Title Phone Number * (###) ### #### Type Of Relations * Check One Below Checking Savings Mortgage Working Capital Line Term Loans Account # * Date Opened MM DD YYYY Vehicle To Be Finance / Terms Requested Year Make Model Mileage Select Vehicle Type New Used Amount of Loan Requested Type dollar amount Loan Term Requested Type Months Requested Please Select Below Replacement Vehicle Addition to Fleet Please Sign Below Acknowledgement * By typing your name in the box below, you are electronically signing this form. The undersigned certifies that the above information given for credit purposes is true and correct and authorizes Auto Funding Corp., (or assigns) and any credit bureau or investigative agency too investigate the references, statements, or other data listed accompanying this application. The undersign authorizes all parties contacted to release credit and financial information requested as part of said investigation. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applications on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract) because all or part of the applicant's income derives from any public assistance program, or because the applicant has in good faith excercised any right under the Consumer Credit Protection Act. Accept Applicant Signature #1 * Please type name below. First Name Last Name Applicant Signature #2 First Name Last Name Todays Date * MM DD YYYY Thank you! Download a PDF version of Credit App click here
