FRESH START HOTLINE CREDIT APPLICATION
First Name
*Required
Last Name
Middle Initial
Social Security Number
Date of Birth
Home Address
City
State
Zip Code
Years at Current Residence
Own or Rent or Live with Family
Select Own Rent Live with Family *Required
Current Monthly Rent or Mortgage Payment
Years with Employer
Current Place of Employment
Name of Employer
Monthly Income Before Taxes
Bank
Bank Account Type
Trade In
YesNo *Required
Year
Make
Model
Mileage
Condition
Select Rough Average Excellent *Required
Home Telephone
Work Telephone
Email Address
Type of Vehicle Needed
Select 2-Door Car 4-Door Car Minivan Full Size Van Small Truck Full Size Truck Sports Utility *Required
Type of Transmission
Select Manual Automatic Does not Matter *Required
In order to process your application, the lender requires a down-payment amount to be entered:
Maximum Down Payment
We accept trade-ins that are paid for or nearly paid for that are in an equitable position.
Qualified Trade-in
If you have a co-buyer, someone who will be financing the car with your, please submit your information first by completing this form and clicking on the “Submit" button below. Then clear the form by clicking the "Reset" button below and fill out a new form for the co-buyer. .
Comments or Questions
That's it! Just click on the Submit Button One Time to Send Your Application to our Processing Center.
Thank You!
By submitting this form you agree to allow Fresh Start Hotline or one of our affiliate dealers to access your credit report to determine your credit score.