800 Highway 5 South
Tipton, MO 65081
660-433-5545
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Applicant / Cosigner Information
*First Name, Middle Initial
*Last Name
*Email Address
*Day Phone Number
Evening Phone Number
Date of Birth
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Social Security Number
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Driver's License
Employment Information
Employer
Occupation
Supervisor
Business Phone
Employment Status
Employed Full Time
Employed Part Time
Self Employed
Temp Service
Unemployed
Student
Retired
Fixed Income
Homemaker
Other
Employment Start Date
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Gross Salary before taxes
$
per
Year
Month
Week
Housing Information
Address
City, State, Zip
state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Residence Move-in Date
January
February
March
April
May
June
July
August
September
October
November
December
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
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2006
2005
2004
2003
2002
2001
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1998
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1921
1920
1919
Residence Status
Rent
Own
Military Housing
Live with Parents
Other
Housing Payment
$
per month
Other
Available Down Payment
$
Select Vehicle(s) of Interest
18 Chevrolet Cruze LT $14,599
10 Chevrolet Impala LT $8,700
17 Chevrolet Malibu LS $14,980
06 Chevrolet Silverado 1500
14 Chevrolet Silverado 1500 W/T $13,680
13 Chevrolet Traverse LTZ $12,599
17 Chrysler Pacifica Touring $17,980
15 Dodge Challenger SXT Plus $21,999
12 Dodge Durango Crew $13,900
16 Dodge Grand Caravan SE $15,999
17 Ford Escape SE $13,795
03 Ford Expedition Eddie Bauer $3,350
18 Ford Expedition Limited
13 Ford Expedition EL Limited $21,999
15 Ford Explorer Limited $21,980
16 Ford Explorer Limited $27,980
17 Ford F-150
17 Ford F-150 2WD XL Reg Cab $20,799
17 Ford F-150 4WD XLT SuperCrew $36,970
16 Ford F-150 XL $20,960
17 Ford F-150 XL $22,500
14 Ford Focus S $6,990
04 Ford Freestar Wagon SES $3,980
16 Ford Fusion SE $12,900
17 Ford Fusion SE $14,999
04 Ford Super Duty F-250 Lariat $7,980
11 Ford Super Duty F-250 SRW XL $14,980
15 Ford Super Duty F-350 SRW XLT $31,980
15 Ford Super Duty F-750 Straight Frame XLT $44,900
11 Ford Taurus Limited $7,400
13 Ford Taurus Limited $12,699
03 Ford Thunderbird Premium $22,399
17 GMC Canyon 4WD Denali Crew Cab $31,999
17 GMC Canyon 4WD SLE Crew Cab $26,999
17 GMC Sierra 1500 4WD SLT Crew Cab $36,599
13 GMC Terrain SLT $8,450
17 Honda Accord Sedan LX $15,499
17 Honda Civic Hatchback Sport $18,899
17 Honda CR-V LX $20,499
12 Honda Fit Sport $10,999
14 Honda Pilot EX-L $17,399
16 Honda Pilot EX-L $23,899
16 Honda Pilot Touring $24,699
16 Hyundai Sonata 2.4L Sport $15,799
09 Jayco Eagle 345 $15,980
16 Jeep Renegade 4WD Trailhawk $19,899
16 Jeep Wrangler Unlimited Sahara $29,799
18 Kia Forte5 LX $13,599
16 Kia Optima SX Turbo $20,999
15 Kia Sportage LX $14,899
18 Lincoln Continental Reserve
10 Mercury Milan Premier $6,950
13 Mitsubishi Lancer Evolution GSR $26,499
18 Nissan Pathfinder SL $27,399
17 Nissan Rogue S $15,360
09 Pontiac Vibe w/1SB $5,200
14 Ram 1500 4WD Sport Reg Cab $24,999
15 Subaru Outback 2.5i Premium $13,900
17 Toyota 4Runner Limited $35,975
14 Toyota 4Runner Trail $32,475
19 Toyota 4Runner TRD Off Road $38,399
19 Toyota 4Runner TRD Off Road $37,899
19 Toyota 4Runner TRD Off Road $38,499
10 Toyota Camry LE $9,599
16 Toyota Camry SE $16,999
17 Toyota Camry SE $18,475
17 Toyota Camry SE $17,975
18 Toyota Camry SE $22,575
18 Toyota Camry SE $22,475
17 Toyota Camry XSE $20,975
17 Toyota Camry Hybrid LE $19,875
16 Toyota Corolla LE $15,975
16 Toyota Corolla LE $14,475
17 Toyota Corolla LE $15,475
17 Toyota Corolla LE $15,575
17 Toyota Corolla LE $15,575
16 Toyota Corolla S $15,599
14 Toyota Corolla S Plus $8,900
17 Toyota Corolla SE $16,475
19 Toyota Corolla Hatchback SE $18,975
13 Toyota FJ Cruiser $17,900
16 Toyota Highlander LE $25,775
17 Toyota Highlander LE $28,475
18 Toyota Highlander LE $28,975
16 Toyota Highlander LE Plus $25,875
16 Toyota Highlander LE Plus $26,775
16 Toyota Highlander XLE $27,375
16 Toyota Highlander XLE $29,475
13 Toyota Prius Four $8,500
11 Toyota Prius II $12,499
15 Toyota Prius c Two $15,575
16 Toyota RAV4 LE $18,975
16 Toyota RAV4 LE $18,875
17 Toyota RAV4 LE $18,675
12 Toyota RAV4 Limited $13,499
10 Toyota RAV4 Ltd $11,699
17 Toyota RAV4 XLE $21,475
17 Toyota RAV4 XLE $22,875
17 Toyota RAV4 XLE $20,275
17 Toyota RAV4 XLE $21,375
16 Toyota RAV4 Hybrid Limited $26,975
17 Toyota RAV4 Hybrid Limited $26,975
16 Toyota RAV4 Hybrid XLE $22,575
12 Toyota Tacoma 4WD Double Cab $21,999
17 Toyota Tacoma 4WD TRD Off Road Access Cab $29,975
16 Toyota Tacoma 4WD TRD Sport Double Cab $31,999
19 Toyota Tundra 4WD 4WD TRD Pro CrewMax $45,999
19 Toyota Yaris Sedan LE $14,999
17 Volvo XC60 T5 Dynamic $22,399
Comments / Questions
Terms : I certify that the above information on this application for credit and any attachments I may send regarding this application are accurate and complete. I authorize and instruct any person or consumer reporting agency to compile and furnish any information it may have that may be required for the purpose of a credit transaction and agree same information shall remain your property whether or not credit is extended. I authorize you to obtain information from others concerning my credit standing and other relevant information impacting on this application and to provide others with information about your experience with me. I understand that I must update this credit information at your request and if this credit information changes.
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