Dave White Auto Credit :: Credit Application

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First Name:

Birth Date:

xx/xx/xxxx

Initial:

. (If none, leave blank.)

S.S. Number:

- - xx-xx-xxxx

Last Name:

Home:

Rent Own

(Check Only One.)

Current
Address:

Monthly Payment:

How Long at Current Address?:

Gross Income:

$ .00 (Monthly)

Apartment #:

(If none, leave blank.)

Phone:

- - xxx-xxx-xxxx

City:

Email:

State:

Before Applying:

Zip Code:

I am 18 years of age or older.

Years at Address:

I have a valid driver's license.

I have read & agree to Terms.

I have read & agree to Privacy Policy.

By clicking the "Submit Form" button below, you agree to our Conditions & Privacy Policy and authorize
us to perform a credit check in order to evaluate financing options which we can provide you.

Applicant hereby authorizes Dave White Auto Credit or any credit bureau or other investigation agency employed by Dave White Auto Credit to investigate any company given by applicant or statements or other data obtained from applicant or any other person pertaining to applicant's credit & financial responsibility. Applicant also authorizes Dave White Auto Credit to furnish to other persons, upon request, information concerning applicant's credit & financial transactions or experiences with the bank. Ohio residents - THE OHIO LAWS AGAINST DISCRIMINATION REQUIRE THAT ALL CREDITORS MAKE CREDIT EQUALLY AVAILABLE TO ALL CREDITWORTHY 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. The applicant represents that all other information contained in this application for credit is true, complete, and correct. The applicant has listed all requested debt information on this application & understands that the bank will rely on the truth of the foregoing statements in granting credit to the applicant.