Credit Application

Your information

First Name *

Last Name *

Email *

Home phone

Cell Phone *

Date of Birth *

Social Security Number *

Citizenship *

Your Address

Street Address *

City *

Zip *

State *

Own or Rent? *

Own

Rent

Your Vehicle

Year *

Make *

MOdel *

Body Type *

New or Used? *

New

Used

Mileage

If you found a car online that you are interested, add the link here:

VIN

Selling Price *

Down Payment *

Lease Amount *

Term of lease *

Current Employment

Company *

Street Address *

City *

Zip *

State *

Employer phone *

Years Employed *

Position *

Annual Income *

Comments

* Declaration and Authorization Statement:

The undersigned individual, on behalf of themselves and all others listed on this application, recognizing that their individual credit history may be a factor in the evaluation of the credit of the applicant, hereby consents to and authorizes Putnam Leasing and any assignee, lender, or funding source that may be utilized to obtain and use a consumer credit report on the undersigned, now and from time to time, as needed in the credit evaluation and review process, and waives any right or claim they would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent.

To help the government fight the funding of terrorism and money laundering activities, Federal Law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What does this means for you: When you open an account, we will ask for your name, address, date of birth (for individuals) and other information that will allow us to identify you. We will also ask for a copy of your driver’s license (for individuals) or other identifying documents.

* Indicate that you understand and agree with the above statement by typing your name below:

Submit Application