📞 417-335-4499|1069 State Hwy 165, Branson, MO 65616|Mon–Fri 9:00–5:30
Get Pre-Qualified

Application for Credit

Fall Creek
Motors Inc.

Please complete all appropriate sections, providing at least two years residence and employment history. If additional space is needed, please use back of this application.

READ TO APPLICANT: "If married, you have the right to apply for credit separately from or jointly with your spouse."

Purpose
Amount Requested
Source
Applicant
Name (Last, First, Middle) *
Social Security No.
Date of Birth
Residence Address (Street, City, State, Zip)
How Long? Yrs.
Mos.
Mailing Address (if different from Residence)
Home Phone No.
Cell Phone No.
Previous Address (if less than 2 years)
How Long? Yrs.
Mos.
No. Dependents
Email Address *
Housing Status
Landlord or Mortgage Holder
Mortgage or Rent Payment /Mo
Employment — Applicant
Employer's Name and Address
Occupation
How Long? Yrs.
Mos.
Work Phone No.
Ext.
Monthly Income Gross
Monthly Income Net
Previous Employer
Yrs.
Mos.
All Other Monthly Income Gross
Source(s) of Other Income
Total Monthly Income Gross
Total Monthly Income Net

*OTHER INCOME: (Read to applicant: "Income from alimony, child support, or separate maintenance need not be revealed if you do not choose to rely on such income in applying for credit.")

Are you obligated to pay alimony, child support, etc.?
Vehicle(s) Being Financed
Auto Yr / Model
Model
Financed By
Auto Yr / Model
Model
Financed By

I/We the undersigned Applicant(s) for credit do hereby affirm that the information contained in this application is true and correct in all respects and I/we understand that it will be relied upon by Lendmark Financial Services, LLC, its subsidiaries and affiliates ("Lendmark"), and any seller of goods who may be assigning a retail installment sales contract to Lendmark ("Seller"), in making the decision to extend credit to me/us. I/we authorize Lendmark and Seller, if applicable, to make whatever inquiries they deem necessary to verify the information contained in this application, including, but not limited to, obtaining my/our personal credit reports. I/we authorize any person or credit reporting agency to provide any information that they may have about me/us in response to such inquiries and agree that such information, together with this application, shall be the property of Lendmark and Seller, as applicable, whether or not credit is extended.

OH DISCLOSURE: OH DISCLOSURE: 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.

CA DISCLOSURE: CA DISCLOSURE: Married persons may apply for separate accounts.

Signatures & Identification
Driver's License No. and State (or State I.D. No.)
Applicant's Signature
Date

CONSUMER APP/REV 04/17

Prefer a paper form?
Print and bring this completed form to our lot at 1069 State Hwy 165, Branson, MO.
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Fall Creek Motors printable credit application form