ONLINE CREDIT APPLICATION


Roper MotorSports
Joplin, MO


* required information.

YOUR PERSONAL INFORMATION :
How did you hear about Roper MotorSports?
*Full Name (first / middle / last) :
*Social Security #: - -
*Driver's License #:
*Date of Birth (mo/day/year): / /
*Home Address ( # / street / apt)
*City/State/Zipcode: ,
*Do you have a phone or utility bill in your name?


*Do you have a checking account in your name?


*Do you have a savings account in your name?


*Rent or Own:
*Rent or Mortgage Amount:
*Residency Length: Years    Months
*Home Telephone: - -
*Email address :
Previous Address (If less than 2 years at your current address):
Address ( # / street / apt)
City/State/Zipcode: ,

EMPLOYMENT INFORMATION :
*Current Employer :
*Self Employed? :
*Job Title :
*Work Telephone : - -  ext.
*Employment Length : Years    Months
*Monthly Income (before tax) :
PREVIOUS EMPLOYMENT INFORMATION :
Previous Employer :
Self Employment :
Job Title :
Work Telephone : - -
Employment Length : Years    Months

ADDITIONAL INCOME INFORMATION* (optional):
* Alimony, child support, spousal income and separate maintenance income need not be disclosed if you do not wish to have it considered as a basis for repaying this obligation.
Amount (annual) :
Source :

DOWN PAYMENT / VEHICLE INTERESTED IN / TRADE-IN INFORMATION:
Let us know which vehicle you are interested in. If you are planning on trading in a vehicle please enter the information below.
Cash down payment:

What vehicle do you want to purchase?:

Desired Monthly Payment :


YOUR TRADE-IN INFORMATION (optional):
Year :
Make and Model :
Mileage :

Additional Trade-In details (condition issues, etc..) or information:


In submitting this credit application, I certify that the information provided on this application is, to the best of my knowledge, complete and accurate. I understand that Roper MotorSports and financial institution(s) will rely on this information to judge my credit worthiness, and will retain this application and information about me whether or not this application is approved. Further, I authorize an investigation of my credit and employment history, in conjunction with which my credit report may be obtained from one or more consumer credit reporting agencies. I understand that false statements may subject me to criminal penalties. I further understand that Roper MotorSports and/or the financial institution(s) that evaluate my application may require additional information.

FAIR CREDIT REPORTING ACT DISCLOSURE: I understand that this application for credit will be submitted by Roper MotorSports to various financial institutions for evaluation.

 

* I agree to the terms and conditions of this application listed above and give permission to Roper MotorSports 902 N Range Line Rd, Joplin, MO 64801 to run an automotive credit check on my behalf.