Midwest Auto
For A Great Deal On Your Next Vehicle

Credit Application

Midwest Auto's Credit Application

To Get Approved You Must Have An Iowa Driver's License, Be At Least 18 Years Old & Be On You Job At Least 6 Months.
Keep In Mind This Application May Take Up To 1 Business Day To Get Approved Or Declined.

Applicant Information
(Applicant) Full Name: *
(Applicant) Phone Number:
(Applicant) Home Address: *
(Applicant) Years At Address: *
(Applicant Birth) date: *
(Applicant) Social Security: *
(Applicant) Driver's License: *
(Applicant) Expiration Date: *
(Applicant) Email Address:
Marital Status:
Do You?:
(Applicant) House Payment: *	$per month
(Applicant) Land Lord:
(Applicant) Land Lord Ph.#:
(Applicant) Employer: *
(Applicant) Position: *
(Applicant) Employer Address: *
(Applicant) Employer Ph. #: *
(Applicant) Start Date:
(Applicant) Monthly Gross: *	$ (before taxes)
(Applicant) Monthly Net: *	$ (after taxes)
(Applicant) Additional Income:	$per month
(Applicant) Received From:
(Applicant) Bank:
	(Applicant) Checking Account (Applicant) Savings Account
(Applicant) Insurance Company:
	(Applicant) Full CoverageLiability(Applicant) SR22
Co-Applicant Information
(Co-App) Full Name:
(Co-App) Phone Number:
(Co-App) Address:
(Co-App) Years At Address:
(Co-App) Birth date:
(Co-App) Social Security:
(Co-App) Driver's License:
(Co-App) Expiration Date:
(Co-App) Email Address:
Marital Status:
Do You?:
(Co-App) House Payment:	$per month
(Co-App) Land Lord:
(Co-App) Land Lord Ph.#:
(Co-App) Employer:
(Co-App) Position:
(Co-App) Employer Address:
(Co-App) Employer Ph. #:
(Co-App) Start Date:
(Co-App) Monthly Gross:	$ (before taxes)
(Co-App) Monthly Net:	$ (after taxes)
(Co-App) Bank:
	(Co-App) Checking Account(Co-App) Savings Account
(Co-App) Insurance Company:
	(Co-App) Liability(Co-App) Full Coverage(Co-App) SR22
Business References (Person/Co. You Made Payments To)
Reference #1
Business Ref#1 Address:
Business Ref #1 Phone Number:
Business Reference:
Business Ref #2 Address:
Business Ref #2 Phone Number:
Business Reference #3:
Business Ref #3 Address:
Business Ref#3 Phone Number:
Personal Reference (At Least 3)
Personal Ref #1 *
Personal Ref#1 Address: *
Personal Ref#1 Phone Number: *
Personal Ref#2 *
Personal Ref#2 Address: *
Personal Ref#2 Phone Number: *
Personal Reference #3: *
Personal Ref#3 Address: *
Personal Ref#3 Phone Number: *
Personal Reference #4:
Personal Ref#4 Address:
Personal Ref#4 Phone Number:
Personal Reference #5:
Personal Ref#5 Address:
Personal Ref#6 Phone Number:
Applying For
Amount Needing Financed:
Other Information
Comments:	Enter comments here!
	I authorize the employee's of Midwest Auto Sales, Inc. to verify my credit references, check my credit score and employment history.
	I have read the Privacy Policy
	>>If you don't check both boxes you will be automatically declined<<

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Midwest Auto's Privacy Policy

The protection of your nonpublic personal information is important to our dealership. It is common for companies like ours to share your nonpublic personal information with affiliated third parties (a company that is related by common ownership or corporate control) and, in some cases, with non-affiliated third parties. Because we recognize that keeping your nonpublic personal information private is important to you, we would like to take this opportunity to explain our Privacy Policy.

About Our Privacy Policy:
Our Privacy Policy applies to those persons who obtain from us financial products or service to be used for personal, family, or household purposes. Out goal is to respond to your inquiries and to provide products, services and other information you request. The Privacy Policy explains:
-The types of information we may collect about you
-The types of information we may disclose to third parties
-How we protect the nonpublic personal information we collect about you

The Types of Information We May Collect About You:
We may collect nonpublic personal information about you from the following sources:
-Information we receive from you on applications or other forms, such as: your name, address, telephone numbers, email addresses, birth date, social security number, income and employment history.
-Information about your transactions with us or others, such as: your account balances and payments histories.
-Information we receive from your consumer credit reporting agency, such as: your credit worthiness, credit score or credit history.
-Representations made by you to us, such as: your employment history, account balances, payment histories, and your relationship with other persons or entities that you have listed as references.

The Types Of Information We May Disclose:
We may disclose all of the nonpublic personal information that we collect about you as a consumer, customer, or former customer to third parties as permitted by law. We may, also, disclose the nonpublic personal information we collect about you to third parties that perform services on our behalf or in connection with the products and services we sell or other financial institutions with whom we have joint marketing agreements, such as third parties who: manufacture, supply or administer the goods and services, including insurance products, warranties and extended service contracts; advise or market the products and services; make service and customer satisfaction inquiries on our behalf; or provide other related marketing services. We are permitted by law to disclose information about you to third parties that perform such services and/or to other financial institutions with whom we have joint marketing agreements. We are not required to give you the opportunity to opt out of such disclosures.

How We Protect The Nonpublic Personal Information We Collect About You:
We take our responsibility to protect you nonpublic personal information very seriously. Whenever we collect information about you, we restrict access to your nonpublic personal information to our employees and those third parties who need the information to respond to your inquiries, to provide better customer service, and to provide products, services and other information you request. We explain the importance of protecting your nonpublic personal information to our employees and take appropriate measures to enforce employee responsibilities regarding our Privacy Policy. We also maintain physical, electronic and procedural safeguards to protect the confidentiality and security of the information confidential and to use the information only as permitted by law.

We appreciate your business and the opportunity to assist you n understanding our Privacy Policy. We hope that you have found this information to be useful and appreciate the opportunity to continue to serve you in the future. If you have any questions about our privacy policies, please feel free to contact us.

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