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Credit Application

First Name *

Last Name *

Date of birth *

Social Security *

EX: 123-45-6789

Address

Street Address *

City *

State *

Country *

Country

Postal code *

Phone *

Email *

Years at Current Address *

Type of Residence *

Own

Rent

Live with Relatives

Mortgage/Rent Amount *

Applicant Employer Information

Employer *

Position *

Years at Current Job *

Employer Address *

Employer City

Employer State

Employer's Country *

Employer Postal Code *

Employer's Phone Number *

Gross Annual Income *

EX: $12,345

Other Income

EX: $1,234

Co-Applicant *

Yes

No

Co-Applicant's Name *

Co-Applicant's Date of Birth *

Co-Applicant's SSN *

Co-Applicant's Address *

City *

State *

Country *

Code *

Relationship to Applicant *

Co-Applicant's Type of Residence *

Own

Rent

Live with Relatives

Amount of Years at Current Address *

Co-Applicant's Current Employer *

Co-Applicant's Current Position *

Years on the Job *

Co-Applicant's Employer's Address *

City *

State *

Country *

Postal Code *

Employer's Phone Number *

Co-Applicant's Gross Annual Income *

Business *

Yes

No

Business Name (LLC, CORP, SOL) *

EIN *

EX: 12-3456789

Annual Income *

EX: $123,456

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STK Auto

611 Midland Ave, Staten Island NY 10306

(864) 874-6141

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