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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1910
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
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Gross Salary before taxes
$
per
Year
Month
Week
Housing Information
Address
City, State, Zip
state
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Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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Hawaii
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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
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1999
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1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
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1972
1971
1970
1969
1968
1967
1966
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1963
1962
1961
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1953
1952
1951
1950
1949
1948
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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
19 Audi Q7 SE Premium $19,999
24 Chevrolet Equinox LT $21,990
14 Chevrolet Express Cargo Van RWD 2500 135" $9,999
23 Chevrolet Express Cargo Van RWD 2500 135" $28,995
22 Chevrolet Malibu LT $16,899
22 Chevrolet Malibu RS $19,990
23 Chevrolet Silverado 1500 4WD LT Crew Cab $36,990
25 Chevrolet Silverado 1500 LT $42,990
24 Chevrolet Silverado 1500 Work Truck $28,995
24 Chevrolet Silverado 1500 Work Truck $28,995
24 Chevrolet Silverado 1500 Work Truck $28,995
24 Chevrolet Silverado 1500 Work Truck $28,995
24 Chevrolet Silverado 1500 Work Truck $28,995
21 Chevrolet Silverado 2500HD 4WD Custom Double Cab $32,995
25 Chevrolet Trax LT $18,999
24 Ford Bronco Outer Banks $44,990
21 Ford Bronco Sport Big Bend $19,750
21 Ford Bronco Sport Big Bend $21,990
21 Ford Bronco Sport Outer Banks $24,229
24 Ford Bronco Sport Outer Banks $25,995
24 Ford Edge SEL $25,990
23 Ford Edge Titanium $22,990
23 Ford Escape Active $22,990
24 Ford Escape PHEV $28,995
23 Ford Expedition Limited $39,990
17 Ford Expedition XLT
22 Ford Explorer Platinum $31,995
25 Ford Explorer ST-Line $42,995
13 Ford F-150 4WD Lariat SuperCrew $16,995
21 Ford F-150 4WD Lariat SuperCrew $42,342
22 Ford F-150 4WD Lariat SuperCrew $39,995
19 Ford F-150 4WD STX SuperCrew $19,990
17 Ford F-150 4WD XL SuperCrew $15,995
19 Ford F-150 4WD XLT SuperCrew $27,497
20 Ford F-150 4WD XLT SuperCrew $30,995
20 Ford F-150 4WD XLT SuperCrew $24,995
22 Ford F-150 4WD XLT SuperCrew $32,891
23 Ford F-150 4WD XLT SuperCrew $36,750
13 Ford F-150 FX4 $8,999
21 Ford F-650 Straight Frame Gas 2WD Reg Cab $51,990
26 Ford F-750 Straight Frame Gas Reg Cab $77,445
20 Ford Fusion SE $13,628
20 Ford Fusion SE $14,495
18 Ford Fusion Hybrid SE $12,995
22 Ford Super Duty F-250 SRW 4WD XLT Crew Cab $37,990
19 Ford Super Duty F-350 DRW Lariat $49,999
22 Ford Super Duty F-350 SRW 4WD Lariat Crew Cab $56,995
15 Ford Super Duty F-750 Straight Frame XL $35,995
23 Ford Transit Cargo Van T-150 Low Rf 8670 GVWR RWD $32,299
15 Ford Transit Connect XL $8,990
23 Ford Transit Passenger Wagon XL $41,972
08 GMC
23 GMC Sierra 1500 4WD Elevation Crew Cab $44,995
25 GMC Sierra 1500 SLT $55,495
15 GMC Sierra 3500HD 4WD Denali Crew Cab $36,995
20 GMC Yukon XL SLT $26,495
19 Honda Accord Sedan LX 1.5T $19,995
19 Honda Accord Sedan Sport 1.5T $21,995
24 Hyundai Elantra SEL $20,995
19 Hyundai Sonata SE $9,445
24 Hyundai Sonata SEL $21,995
23 Hyundai Tucson Limited $23,995
24 Hyundai Tucson Hybrid SEL Convenience $27,556
20 INFINITI QX60 LUXE $16,995
12 International $12,990
23 Jeep Renegade Trailhawk $20,999
18 Jeep Wrangler JK Unlimited Rubicon Recon $22,352
19 Jeep Wrangler Unlimited Sahara $22,995
22 Kia Telluride SX $27,995
24 Mazda CX-90 3.3 Turbo Select $28,990
13 Mazda Mazda3 Sedan i Grand Touring $8,495
24 Mitsubishi Eclipse Cross SE $21,990
24 Mitsubishi Mirage ES $16,199
22 Mitsubishi Outlander Black Edition $22,990
24 Nissan Altima 2.5 S $18,495
25 Nissan Altima SV $22,990
24 Nissan Rogue S $23,995
23 Nissan Rogue SV $20,998
15 Ram 1500 4WD Laramie Longhorn Crew Cab $22,495
19 Ram 1500 Classic Tradesman $22,995
18 Toyota Camry LE $18,399
15 Toyota Corolla LE ECO $11,995
18 Toyota RAV4 XLE $18,995
22 Volkswagen Tiguan SE $21,495
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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