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
-
-
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
February
March
April
May
June
July
August
September
October
November
December
2026
2025
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2022
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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
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
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
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
Residence Status
Rent
Own
Military Housing
Live with Parents
Other
Housing Payment
$
per month
Other
Available Down Payment
$
Select Vehicle(s) of Interest
18 Buick Regal Sportback Preferred $17,409
19 Cadillac CT6 Sport AWD $22,250
24 Chevrolet Express Cargo Van $35,995
24 Chevrolet Express Cargo Van RWD 2500 135" $35,995
23 Chevrolet Malibu RS $19,501
20 Chevrolet Silverado 1500 LT Trail Boss $34,990
22 Chevrolet Silverado 1500 LTD 4WD RST Crew Cab $30,499
21 Chevrolet TrailBlazer RS $18,990
23 Chrysler Pacifica Limited $30,990
25 Chrysler Pacifica Limited $38,990
25 Chrysler Pacifica Limited $34,999
23 Chrysler Pacifica Touring L $24,990
24 Chrysler Pacifica Touring L $29,990
24 Chrysler Pacifica Touring L $27,990
24 Chrysler Pacifica Touring L $27,990
19 Dodge Journey SE Value Pkg $12,794
23 Ford Bronco Outer Banks $35,175
23 Ford Bronco Sport Outer Banks $28,749
20 Ford EcoSport SES $14,400
24 Ford Edge Titanium $26,974
24 Ford Edge Titanium $31,688
24 Ford Escape PHEV $25,525
22 Ford Escape SEL $21,990
25 Ford Escape ST-Line $26,999
25 Ford Escape ST-Line $26,849
26 Ford Escape ST-Line $34,345
23 Ford Expedition Limited $37,300
24 Ford Expedition Limited $44,175
22 Ford Explorer Limited $33,995
23 Ford Explorer Limited $38,499
20 Ford Explorer ST $31,400
25 Ford Explorer ST-Line $37,997
25 Ford Explorer ST-Line $40,588
21 Ford F-150 4WD King Ranch SuperCrew $36,598
13 Ford F-150 4WD Platinum SuperCrew $9,449
23 Ford F-150 4WD Tremor SuperCrew $52,990
02 Ford F-150 4WD XLT SuperCrew $6,990
23 Ford F-150 4WD XLT SuperCrew $40,990
23 Ford F-150 4WD XLT SuperCrew $35,990
21 Ford F-150 Lariat $34,467
23 Ford F-150 Tremor $56,990
24 Ford F-150 XL $40,990
14 Ford Focus SE $8,995
12 Ford Fusion SE $3,995
22 Ford Ranger 4WD XLT SuperCrew $24,486
21 Ford Super Duty F-250 SRW 4WD STX $38,995
23 Ford Super Duty F-250 SRW XL $49,990
23 Ford Super Duty F-250 SRW XL $52,995
23 Ford Super Duty F-250 SRW XL $51,995
16 Ford Super Duty F-250 SRW XLT $29,995
23 Ford Super Duty F-550 DRW XL $73,993
23 Ford Super Duty F-550 DRW XL DRW $105,990
24 Ford Transit Cargo Van T-250 Low Rf 9070 GVWR RWD $36,835
24 Ford Transit Cargo Van T-250 Low Rf 9070 GVWR RWD $36,835
22 Ford Transit Cargo Van T-350 148" EL Hi Rf 9500 GVWR AWD
22 Ford Transit Passenger Wagon XLT $36,995
21 GMC Canyon 4WD AT4 w/Leather Crew Cab $31,990
24 GMC Canyon 4WD AT4X $49,225
22 GMC Sierra 2500HD 4WD AT4 Crew Cab $47,943
19 GMC Sierra 3500HD 4WD Denali Crew Cab $41,100
08 GMC TC8500 Regular Cab $13,995
24 Honda Accord Sedan EX $27,850
19 Honda Accord Sedan Sport 1.5T $20,620
21 Honda Civic Hatchback Sport $24,699
20 Honda Civic Sedan EX-L $20,729
24 Honda Civic Sedan Sport $22,428
25 Honda CR-V EX-L $35,990
23 Hyundai Elantra SEL $18,990
22 Hyundai Santa Cruz SEL $16,743
18 Hyundai Sonata Sport $14,400
15 Hyundai Tucson SE $8,990
12 International $10,990
25 Jeep Compass Limited $24,578
23 Jeep Grand Cherokee 4WD Altitude $29,995
21 Jeep Wrangler Rubicon $33,990
18 Jeep Wrangler JK Unlimited Rubicon $21,990
14 Jeep Wrangler Unlimited Altitude $14,649
19 Jeep Wrangler Unlimited Sahara $19,504
24 Mazda CX-30 2.5 S Select Sport $23,152
25 Mazda CX-5 2.5 S Preferred Package $27,578
24 Nissan Sentra SV $19,705
16 Ram 1500 4WD Rebel Crew Cab $23,996
25 Ram 1500 Laramie $47,990
19 Ram 1500 Limited $27,576
23 Ram 1500 Lone Star $29,915
22 Ram ProMaster City Cargo Van Tradesman $15,744
09 Toyota Camry LE $4,295
15 Toyota Camry LE $12,972
22 Volkswagen Tiguan SE $21,122
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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