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Send us your credit information and we can get started
right away on getting you into YOUR new car!
All fields are required for processing Personal
Name: Address:
Time at current address:
Rent or Mortgage:
If less than 2 years at
current address: Previous Address:
Phone
Number: Social Security #:
Drivers License #:
State: Birthdate
(MM/DD/YYYY):
Employment Current Employer:
Address:
Occupation:
Time at job:
Salary (monthly): If less
than 2 years at current employer: Previous Employer:
Address:
Occupation:
Time at job:
Financial
Previous
Reposession
Previous
Bankruptcy Date:
Current Credit
(loans or credit cards):
I give Bishop Automotive,
Inc. d.b.a. Bernie Bishop Mazda the right to use this information for
the purpose of applying for credit for an automobile.
If more than one person are applying for credit please
submit a second form.
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