3401 Clear Lake Ave
Springfield, IL 62702
217-528-0770
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Applicant / Cosigner Information
*First Name, Middle Initial
*Last Name
*Email Address
*Day Phone Number
Evening Phone Number
Date of Birth
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Social Security Number
-
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Driver's License
Employment Information
Employer
Occupation
Supervisor
Business Phone
Employment Status
Employed Full Time
Employed Part Time
Self Employed
Temp Service
Unemployed
Student
Retired
Fixed Income
Homemaker
Other
Employment Start Date
January
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April
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Gross Salary before taxes
$
per
Year
Month
Week
Housing Information
Address
City, State, Zip
state
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
Residence Move-in Date
January
February
March
April
May
June
July
August
September
October
November
December
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
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2003
2002
2001
2000
1999
1998
1997
1996
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1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
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1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
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1945
1944
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1932
1931
1930
1929
1928
1927
1926
1925
Residence Status
Rent
Own
Military Housing
Live with Parents
Other
Housing Payment
$
per month
Other
Available Down Payment
$
Select Vehicle(s) of Interest
24 Chevrolet Equinox LT $22,639
23 Chevrolet Express Cargo Van RWD 2500 135" $30,995
23 Chevrolet Express Cargo Van RWD 2500 135" $30,995
20 Chevrolet Malibu LT $16,495
23 Chevrolet Silverado 1500 4WD Custom Crew Cab $34,995
23 Chevrolet Silverado 1500 4WD LT Crew Cab $38,990
21 Chevrolet Silverado 1500 4WD RST Crew Cab $31,895
21 Chevrolet Silverado 1500 4WD RST Crew Cab $30,895
23 Chevrolet Silverado 1500 4WD RST Crew Cab $39,844
19 Chevrolet Sonic LT
25 Chevrolet Trax LT $24,995
23 Chrysler Pacifica Limited $27,990
21 Ford Bronco Sport Badlands $25,995
21 Ford Bronco Sport Big Bend $19,750
22 Ford Bronco Sport Big Bend $26,550
24 Ford Bronco Sport Outer Banks $30,995
24 Ford Edge SEL $25,990
24 Ford Edge SEL AWD $28,272
23 Ford Escape Active $26,995
14 Ford Escape Titanium $8,100
20 Ford Escape Titanium $15,299
22 Ford Escape Titanium $25,995
20 Ford Explorer Base $23,850
22 Ford Explorer Platinum $35,765
22 Ford Explorer XLT $26,995
24 Ford Explorer XLT $33,990
17 Ford F-150 4WD King Ranch SuperCrew $30,500
22 Ford F-150 4WD Lariat SuperCrew $39,995
23 Ford F-150 4WD Lariat SuperCrew $49,999
19 Ford F-150 4WD Platinum SuperCrew $38,995
19 Ford F-150 4WD XLT SuperCrew $34,999
22 Ford F-150 4WD XLT SuperCrew $34,995
23 Ford F-150 4WD XLT SuperCrew $41,995
23 Ford F-150 4WD XLT SuperCrew $36,750
24 Ford F-150 STX $40,995
24 Ford F-150 XLT $46,995
21 Ford F-650 Straight Frame Gas 2WD Reg Cab $31,995
22 Ford F-650 Straight Frame Gas 2WD Reg Cab $33,995
19 Ford Flex SE
24 Ford Maverick XLT $30,995
24 Ford Mustang GT Premium $52,990
21 Ford Super Duty F-250 SRW 4WD Lariat Crew Cab $50,995
16 Ford Super Duty F-250 SRW XL $28,995
15 Ford Super Duty F-750 Straight Frame XL $35,995
08 Ford Taurus SEL $3,995
23 Ford Transit Cargo Van T-150 Low Rf 8670 GVWR RWD $32,999
23 Ford Transit Cargo Van T-250 Low Rf 9070 GVWR RWD $31,995
23 Ford Transit Cargo Van T-250 Med Rf 9070 GVWR RWD $32,233
23 Ford Transit Passenger Wagon XL $46,000
18 Ford Transit Van T-250 130" Low Rf 9000 GVWR Sliding RH Dr $23,995
23 Ford Transit-350 Base $39,454
23 GMC Sierra 1500 4WD Elevation Crew Cab $47,495
22 GMC Terrain AT4 $24,935
24 GMC Terrain SLE $24,900
96 GMC Topkick $2,995
24 Hyundai Sonata SEL $24,990
22 Jeep Compass (RED) Edition $23,373
22 Jeep Grand Cherokee Laredo $22,962
22 Jeep Grand Cherokee L 4WD Altitude $32,644
23 Jeep Grand Cherokee L 4WD Limited $30,945
23 Jeep Renegade Trailhawk $23,084
20 Jeep Wrangler Rubicon $27,079
20 Kia Optima LX
23 Kia Soul LX $19,995
22 Kia Telluride SX $30,995
19 Lincoln MKC Reserve $18,379
22 Lincoln Navigator Black Label $58,611
23 Mazda CX-30 2.5 S Preferred Package $25,499
21 Mercedes-Benz GLC GLC 300 $28,995
24 Nissan Altima 2.5 S $21,995
23 Nissan Murano SV $24,695
23 Nissan Rogue SV $23,995
24 Nissan Rogue SV $24,810
22 Nissan Sentra SV $18,299
21 Ram 1500 Big Horn/Lone Star
24 Ram 3500 Limited $69,999
19 Subaru Outback Limited $21,995
17 Tesla Model S $24,995
25 Toyota Camry LE $26,495
15 Toyota Corolla LE ECO $15,995
16 Toyota Highlander XLE $13,990
07 Toyota Highlander Hybrid 2WD 4dr w/3rd Row (Natl)
10 Toyota RAV4 4WD 4dr 4-cyl 4-Spd AT (Natl) $6,999
18 Toyota RAV4 XLE $23,974
19 Toyota Tacoma 2WD 2WD SR Access Cab $18,995
24 Toyota Tacoma 4WD TRD Sport $44,990
24 Volkswagen Atlas Cross Sport 2.0T SE w/Technology
22 Volkswagen Tiguan SE $25,499
12 Volkswagen Tiguan SE w/Sunroof & Nav
Comments / Questions
Terms : I certify that the above information on this application for credit and any attachments I may send regarding this application are accurate and complete. I authorize and instruct any person or consumer reporting agency to compile and furnish any information it may have that may be required for the purpose of a credit transaction and agree same information shall remain your property whether or not credit is extended. I authorize you to obtain information from others concerning my credit standing and other relevant information impacting on this application and to provide others with information about your experience with me. I understand that I must update this credit information at your request and if this credit information changes.
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