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Loan Application

Loan Information
 Amount Required: Loan Term:
Down Payment: Trade-in:
       
Contact Information
*First Name: *Last Name:
*Email:
*Home Phone: *Day Phone:
Fax: Preferred Contact:
*Address:
City:
State: Zip:
       
Co-Applicant  (If different from Contact Information)
First Name: Last Name:
SSN: Zip Code:
*Date of Birth:
       
Trade-In Vehicle
Manufacturer: Year:
Model: Miles:
VIN Number:
Lien Holder/Payoff  
       
Employment Information
*Employer:
*Occupation:
*Monthly Income: Time on Job:
*Business Phone:    
*Address:
City:
State: Zip:
       
Other Income
Source: Monthly Income:
       
Applicant Information
*Soc. Sec. No.: *Residence Type:
*Date of Birth MM DD YY
*Monthly Payment:
*Time at Residence:  
       
Additional Information
Message Text:      


I certify that that this information is complete and true. I authorize Latham Motors to investigate my credit and employment history and obtain credit reports.

*Mother's Maiden Name  (Serves as your signature)

 
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