Nearly New Auto and Truck in Menasha and Green Bay, Wisconsin

Online Credit Application		Go to Nearly New Auto & Truck
Online Credit Application - Received:

Applicant

Fields marked with * are required.


First Name*	Date of Birth*
M.I.	S.S.#*	- -
Last Name*

Home Phone:*
Work Phone:
Cell Phone:

Email:

Preferred Contact Method:*

Current Address

Street:*
County:*
City:*
State:*
Zip:*
Mortgage Holder/Landlord:

Years at Residence?*
If less than 2 years previous Job or Residence?
Own or Rent?*
Housing Payment?*

Current Employer

Name:*
Phone:*


Years At Employer?*
Occupation*


Hourly Wage:	HRS/WK:	Or Salary:


Additional Information that may help during our review process (maximum 250 characters)


Vehicle Interested In?

Trade-In Information:

Will there be a Co-Borrower applying with you?

Yes No

Online Credit Application
Page 2

Co-Buyer


First Name*	Date of Birth*
M.I.	S.S.#*	- -
Last Name*

Home Phone:*
Work Phone:
Cell Phone:

Email:

Preferred Contact Method:

Current Address

Street:
County:
City:
State:
Zip:
Mortgage Holder/Landlord:

Years at Residence?
If less than 2 years previous Job or Residence?
Own or Rent?
Housing Payment?

Current Employer

Name:
Phone:


Years At Employer?
Occupation

Hourly Wage:

HRS/WK

Or Salary:


Additional Information that may help during our review process (maximum 250 characters)

Approval Information
For the purpose of securing credit from you, I certify that the above information is true and complete to the best of my knowledge. Applicant further certifies that I have attained the age of majority. Applicant authorizes you, to check my credit and employment history and to provide and/or obtain information about credit experience with me.

Yes No

Online Credit Application

Online Credit Application - Received: