715-834-2277
2211 Birch St, Eau Claire, WI 54703
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Application
Step 1 of 5
20%
Name
*
First
Middle
Last
Date of Birth
*
Date Format: MM slash DD slash YYYY
Social Security Number
*
What is your mother's maiden name?
Email
*
Best Phone Number to Reach You
*
What's your current Address?
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
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Delaware
District of Columbia
Florida
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Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Years
0
1
2
3
4
5
6
7
8
9
10 or More
Months
0
1
2
3
4
5
6
7
8
9
10
11
Do you currently own or rent your home?
I own my home
I rent my home
I stay with Family
I stay with Friends
Are you still making payments on your home?
Yes
No
How much do you personally pay for your mortgage every month?
How much do you personally pay for rent every month?
What is your landlord's name?
What is your landlord's phone number?
You said you stay with family or friends - Can you explain the situation a little more?
Do they charge you to stay there? Do you charge you for utilities? Is this a long term situation?
Which of the following accounts do you currently have?
Checking Account
Savings Account
Prepaid Debit Card
None of the above
What is the name of your primary bank or credit union?
What's your current marital status?
*
Single, never married
Married
Divorced
Separated
Do you have a co-buyer or co-signer?
Yes
No, but I could possibly get one if needed
No, and I do not have anyone that could.
I'm submitting this application to cosign for someone else.
Who are you cosigning for?
Are you Active Military?
Yes
No
Who is your current employer?
Years
0
1
2
3
4
5
6
7
8
9
10 or More
Months
0
1
2
3
4
5
6
7
8
9
10
11
Employer Address
Street Address
Address Line 2
City
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
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Employer Phone
What's your position?
What's your supervisors name?
Are you paid hourly or are you salaried?
Paid Hourly
Salaried
How much do you make per hour?
How many hours do you work a week on average?
What is your salary?
Per
Week
Month
Year
Previous Employment
You've been at your current job one year or less. We'll need to collect some information on your last job as well.
Who was your previous employer?
What was your previous position?
How many years?
0
1
2
3
4
5
6
7
8
9
10 or more
How many months?
0
1
2
3
4
5
6
7
8
9
10
11
Do you have another source of income?
Yes
No
Additional Income Sources
Please list any other income sources you have. Please list the amount received per month, as well as how long you have been receiving it.
Co Applicant Information
We'll need your spouse's information too.
Wisconsin is a marital property state and requires us to collect your spouse's info as well.
Name
First
Middle
Last
Date of Birth
Date Format: MM slash DD slash YYYY
Social Security Number
What is your mother's maiden name?
Email
Best Phone Number to Reach You
Do you live at the same address as the primary applicant?
Yes
No
What's your current Address?
Street Address
Address Line 2
City
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
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Years
0
1
2
3
4
5
6
7
8
9
10 or More
Months
0
1
2
3
4
5
6
7
8
9
10
11
Do you currently own or rent your home?
I own my home
I rent my home
I stay with Family
I stay with Friends
Are you still making payments on your home?
Yes
No
How much do you personally pay for your mortgage every month?
How much do you personally pay for rent every month?
What is your landlord's name?
What is your landlord's phone number?
You said you stay with family or friends - Can you explain the situation a little more?
Do they charge you to stay there? Do you charge you for utilities? Is this a long term situation?
Which of the following accounts do you currently have?
Checking Account
Savings Account
Prepaid Debit Card
None of the above
What is the name of your primary bank or credit union?
What's your current marital status?
Single, never married
Married
Divorced
Are you Active Military?
Yes
No
Co Applicant Employment Information
Who is your current employer?
Years
0
1
2
3
4
5
6
7
8
9
10 or More
Months
0
1
2
3
4
5
6
7
8
9
10
11
Employer Phone
What's your position?
Employer Address
Street Address
Address Line 2
City
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
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
What's your supervisors name?
Are you paid hourly or are you salaried?
Paid Hourly
Salaried
How much do you make per hour?
How many hours do you work a week on average?
What is your salary?
Per
Week
Month
Year
Previous Employment
You've been at your current job one year or less. We'll need to collect some information on your last job as well.
Who was your previous employer?
What was your previous position?
How many years?
0
1
2
3
4
5
6
7
8
9
10 or more
How many months?
0
1
2
3
4
5
6
7
8
9
10
11
Do you have another source of income?
Yes
No
Additional Income Sources
Please list any other income sources you have. Please list the amount received per month, as well as how long you have been receiving it.
Do you have a certain vehicle or type of vehicle in mind?
Do you have a trade in?
Yes
No
Is your trade in paid off?
Yes
No
Trade Year
Trade Make
Trade Model
Approximately how many miles?
How much do you owe on your trade-in?
Who do you owe to?
Any problems with your trade?
With our $3000 minimum trade in special, any problems with the vehicle will not hurt you.
Please upload any pictures you may have of your trade in.
Drop files here or
Are you or your cosigner anything other than a US Citizen or Permanent Resident
Yes
No
Have you or you cosigner ever filed for bankruptcy?
Yes
No
Have you or your co-signer had property repossesed or foreclosed upon in the last 7 years?
Yes
No
Do you or your cosigner have any judgements or garnishments?
Yes
No
Do you or your cosigner have any back child support?
Yes
No
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