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
February
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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
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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
2000
1999
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1993
1992
1991
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1987
1986
1985
1984
1983
1982
1981
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1979
1978
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1972
1971
1970
1969
1968
1967
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1962
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1953
1952
1951
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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
22 Chevrolet Express Cargo Van RWD 2500 135" $29,490
13 Chevrolet Malibu LS $6,990
03 Chevrolet Tracker Base
14 Chevrolet Traverse LT $10,400
22 Chevrolet Trax LS $17,999
23 Chrysler Pacifica Limited $29,990
22 Chrysler Pacifica Touring L $20,989
23 Dodge Charger GT $28,899
21 Ford Bronco Sport Big Bend $19,750
22 Ford E-Series Cutaway E-350 WB $28,990
22 Ford E-Transit Cargo Van $36,749
18 Ford Edge Sport
21 Ford Escape SE $14,975
18 Ford F-150 4WD Lariat SuperCrew $21,990
22 Ford F-150 4WD Lariat SuperCrew $36,990
20 Ford F-150 4WD XLT SuperCrew $25,990
23 Ford F-150 4WD XLT SuperCrew $35,990
20 Ford F-150 Lariat $25,990
22 Ford F-150 Lariat $44,999
14 Ford F-150 SVT Raptor $26,988
24 Ford F-150 XL $69,990
12 Ford F-150 XLT $13,990
21 Ford F-650 Straight Frame Gas 2WD Reg Cab
22 Ford F-650 Straight Frame Gas 2WD Reg Cab
17 Ford F-750SD Base $38,990
23 Ford Maverick AWD XLT SuperCrew $28,990
21 Ford Mustang EcoBoost Premium $23,990
22 Ford Mustang EcoBoost Premium $25,990
08 Ford Super Duty F-250 SRW 4WD Lariat Crew Cab $10,500
24 Ford Super Duty F-350 SRW 4WD SuperCab Box $62,990
20 Ford Super Duty F-450 DRW 4WD XL Reg Cab $61,750
23 Ford Transit Cargo Van T-150 Low Rf 8670 GVWR RWD $36,490
24 Ford Transit Cargo Van T-250 148" Med Rf 9070 GVWR AWD $70,990
22 Ford Transit Cargo Van T-250 Low Rf 9070 GVWR RWD $31,990
22 Ford Transit Cargo Van T-250 Low Rf 9070 GVWR RWD $31,990
23 Ford Transit Cutaway T-350 AWD SRW WB 9500 GVWR $65,975
23 Ford Transit Passenger Wagon XL $52,990
96 GMC Topkick
15 Hino 24 Foot Box Truck N/A $17,750
14 Hyundai Genesis Coupe 3.8 Grand Touring $14,990
14 International 4000 box van $29,750
20 Jeep Cherokee 4WD Latitude $18,990
14 Jeep Cherokee 4WD Trailhawk $14,991
22 Jeep Compass 4WD Trailhawk $19,990
23 Jeep Grand Cherokee L 4WD Limited $32,989
15 Jeep Wrangler Unlimited Unlimited Sahara $21,998
17 Jeep Wrangler Unlimited Unlimited Sport S $18,990
10 Lexus ES 350 4dr Sdn $10,990
19 Nissan Altima 2.5 S $15,990
23 Nissan Rogue SV $21,989
22 Nissan Sentra SV $19,990
17 Toyota 4Runner
25 Toyota Camry LE $29,749
25 Toyota Camry LE $29,749
21 Toyota Highlander XLE $29,989
14 Toyota Tundra 4WD Truck 4WD 1794 CrewMax $14,980
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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