1815 West Main St Salem, IL 62881
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618-548-1711
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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
January
February
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Gross Salary before taxes
$
per
Year
Month
Week
Housing Information
Address
City, State, Zip
state
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Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
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Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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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
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
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2002
2001
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1997
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1991
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1985
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1982
1981
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1979
1978
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1970
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1961
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1931
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1926
1925
1924
Residence Status
Rent
Own
Military Housing
Live with Parents
Other
Housing Payment
$
per month
Other
Available Down Payment
$
Select Vehicle(s) of Interest
22 Chevrolet Silverado 1500 4WD Custom Crew Cab $38,998
16 Chevrolet Suburban LT $23,998
22 Chevrolet TrailBlazer LT $23,998
20 Chrysler Pacifica Launch Edition $29,998
22 Chrysler Pacifica Touring L $24,998
20 Dodge Challenger R/T $29,998
21 Dodge Durango Citadel $39,998
24 Ford Bronco Sport Big Bend $30,998
22 Ford Bronco Sport Outer Banks $24,998
19 Ford EcoSport SE $16,998
21 Ford EcoSport SE $18,998
21 Ford EcoSport SES $18,998
22 Ford Edge SEL AWD $30,998
22 Ford Edge SEL AWD $30,998
22 Ford Edge SEL AWD $29,998
20 Ford Expedition Max Limited $41,998
18 Ford Expedition Max XLT $29,998
20 Ford Explorer Limited $24,998
19 Ford Explorer XLT $22,998
21 Ford Explorer XLT $31,998
21 Ford Explorer XLT $32,998
21 Ford Explorer XLT $31,998
22 Ford Explorer XLT $37,998
23 Ford Explorer XLT $38,998
22 Ford F-150 4WD Lariat SuperCrew $48,998
22 Ford F-150 4WD Lariat SuperCrew $49,998
22 Ford F-150 4WD Lariat SuperCrew $48,998
19 Ford F-150 4WD Raptor SuperCrew $57,998
18 Ford F-150 4WD XLT SuperCrew $24,998
22 Ford F-150 4WD XLT SuperCrew $42,998
22 Ford F-150 4WD XLT SuperCrew $42,998
22 Ford F-150 4WD XLT SuperCrew $43,998
22 Ford F-150 4WD XLT SuperCrew $43,998
22 Ford F-150 4WD XLT SuperCrew $42,998
24 Ford F-150 XLT $50,998
24 Ford F-150 XLT $49,998
19 Ford Flex SEL $25,998
22 Ford Maverick 2WD Lariat SuperCrew $33,998
23 Ford Mustang GT Premium $45,998
22 Ford Ranger 4WD XLT SuperCrew $36,998
24 Ford Super Duty F-250 SRW $52,998
22 GMC Acadia SLE $28,998
16 GMC Sierra 3500HD 4WD Denali Crew Cab $43,998
23 INFINITI QX60 PURE $39,998
22 Jeep Grand Cherokee WK 4WD Limited $35,998
23 Jeep Wrangler Rubicon $44,998
23 Lincoln Aviator Black Label $63,998
23 Lincoln Aviator Black Label $64,998
23 Lincoln Aviator Black Label $63,998
23 Lincoln Aviator Reserve $63,998
20 Lincoln MKZ Standard $23,998
23 Lincoln Nautilus Reserve $41,998
23 Lincoln Nautilus Reserve $42,998
18 Lincoln Navigator L Reserve $37,998
23 Lincoln Navigator L Reserve $83,998
23 Nissan Altima 2.5 SV $24,998
19 Nissan Murano SV $16,998
23 Toyota Corolla LE $22,998
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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