1911 E. Edwardsville Rd
Wood River, IL 62095
Call Us Today: 618-216-8080
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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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1910
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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April
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December
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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
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
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1999
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1992
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1986
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1984
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1981
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1930
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1928
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1926
1925
Residence Status
Rent
Own
Military Housing
Live with Parents
Other
Housing Payment
$
per month
Other
Available Down Payment
$
Select Vehicle(s) of Interest
21 Audi Q5 Premium $23,000
23 BMW X1 xDrive28i $31,800
18 Buick Enclave Premium $17,800
14 Buick Encore Convenience
19 Cadillac CT6 Premium Luxury AWD $30,000
21 Cadillac Escalade Sport Platinum $69,999
22 Chevrolet Blazer LT $24,100
21 Chevrolet Colorado 4WD ZR2 Crew Cab $39,000
14 Chevrolet Equinox LT
19 Chevrolet Equinox LT
23 Chevrolet Equinox LT $23,500
21 Chevrolet Equinox Premier $23,400
18 Chevrolet Suburban LT $18,250
23 Chevrolet TrailBlazer ACTIV $25,800
22 Chevrolet TrailBlazer RS $22,625
25 Chevrolet Trax ACTIV $25,999
17 Chrysler Pacifica Touring $11,990
22 Chrysler Voyager LX $21,000
23 Chrysler Voyager LX $21,900
21 Dodge Charger SXT $20,259
22 Dodge Charger SXT $20,900
15 FIAT 500 Sport
16 Ford Escape SE $10,000
20 Ford F-150 4WD Lariat SuperCrew $39,000
18 Ford Fusion Titanium
23 Genesis G70 3.3T $38,467
19 GMC Acadia SLE $16,995
22 GMC Acadia SLE $26,900
23 GMC Sierra 2500HD 4WD SLT Crew Cab $57,500
18 Honda HR-V EX $18,900
20 Hyundai Kona Ultimate $22,900
23 Hyundai Santa Cruz SEL Premium $27,900
22 Hyundai Santa Fe Hybrid SEL Premium $26,500
18 Hyundai Sonata SEL $13,500
20 Hyundai Sonata SEL Plus $16,990
18 Jeep Wrangler Unlimited Sport S $26,990
21 Kia Forte GT $18,900
22 Kia Forte GT $22,400
23 Kia Forte GT $23,700
24 Kia Forte GT $24,490
22 Kia Forte LXS $21,250
24 Kia Forte LXS $20,000
24 Kia Forte LXS $20,000
24 Kia Forte LXS $20,500
24 Kia Forte LXS $19,700
24 Kia Forte LXS $20,000
24 Kia Forte LXS $20,000
21 Kia K5 GT-Line $14,990
22 Kia K5 GT-Line $25,000
23 Kia K5 GT-Line $25,700
24 Kia K5 GT-Line $26,200
20 Kia Optima LX $15,000
24 Kia Seltos EX $24,900
25 Kia Seltos EX $26,500
21 Kia Seltos S $19,150
24 Kia Seltos S $26,864
21 Kia Sorento S $20,695
21 Kia Sorento S $20,000
22 Kia Sorento S $25,990
22 Kia Sorento S $23,950
24 Kia Sorento S $34,500
24 Kia Sorento S $33,800
22 Kia Sorento SX $33,000
24 Kia Sorento SX $35,500
24 Kia Sorento SX $35,500
22 Kia Sorento SX Prestige $28,250
24 Kia Sorento X-Line SX Prestige
22 Kia Soul LX $19,990
16 Kia Sportage EX $10,250
23 Kia Sportage EX $26,500
24 Kia Sportage EX $23,900
23 Kia Sportage LX $22,900
22 Kia Sportage Nightfall $23,800
21 Kia Sportage S $22,900
21 Kia Sportage S $13,990
22 Kia Sportage SX Turbo $23,999
22 Kia Telluride EX $33,500
20 Kia Telluride LX $20,000
22 Kia Telluride S $28,795
22 Kia Telluride SX $35,500
23 Mazda CX-30 2.5 S Select Package $23,400
15 Mazda CX-5 Touring $14,995
21 Mazda CX-5 Touring $19,760
23 Ram 1500 4WD Big Horn Crew Cab $42,000
24 Ram 1500 Classic SLT $34,500
21 Subaru Ascent Premium $22,200
20 Subaru Crosstrek Limited $24,400
16 Toyota RAV4 LE
21 Toyota RAV4 XLE $24,500
23 Volkswagen Atlas 2.0T SE w/Technology $27,990
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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