Finance Application | Selikane Exclusive Motors

Loan Application

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Year:

Motorized Type:

Make:

Model:

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General Information

First Name:

Last Name:

Date of Birth:

Identity Document:

Email Address:

Address:

City:

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Phone Number:

Cell Phone:

Employment Information

Employer:

Status:

Phone:

Ext:

Gross Monthly Income:

Time Employed:

Housing Information

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Own Rent Other

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Credit Score & Comments

Credit Score or Range (i.e. 725 or 700-750):

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By submitting this credit application, I further authorize an investigation of my credit and employment history. Call us at (016) 880-0005 for any questions

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