CREDIT APPLICATION

NAME: ___________________________________________________________________________________________

SSN: _____________________________________________________________________________________________

DATE OF BIRTH:____________________________________________________________________________________

DRIVER'S LICENSE NUMBER: __________________________________________________________________________

ADDRESS:__________________________________________________________________________________________

HOME PHONE: _____________________________________________________________________________________

MOBILE PHONE: ____________________________________________________________________________________

E-MAIL ADDRESS:___________________________________________________________________________________

NUMBER OF YEARS AT CURRENT ADDRESS: ______________________________________________________________

PREVIOUS ADDRESS: (TO COVER 5 YEARS) ______________________________________________________________

      NUMBER OF YEARS:______________________________________________________________________________

PREVIOUS ADDRESS: ________________________________________________________________________________

      NUMBER OF YEARS :_____________________________________________________________________________

OCCUPATION/RANK: ________________________________________________________________________________

EMPLOYER:_________________________________________________________________________________________

      ADDRESS: _____________________________________________________________________________________

      PHONE NUMBER: ________________________________________________________________________________

      GROSS MONTHLY INCOME:________________________________________________________________________

      NUMBER OF YEARS AT CURRENT MPLOYMENT:________________________________________________________

PREVIOUS EMPLOYMENT:(TO COVER 5 YEARS)___________________________________________________________

      ADDRESS: ___________________________________________________________________________________

      PHONE NUMBER: ________________________________________________________________________________

      NUMBER OF YEARS:______________________________________________________________________________

PREVIOUS EMPLOYMENT:_____________________________________________________________________________

      ADDRESS:______________________________________________________________________________________

      PHONE NUMBER:________________________________________________________________________________

      NUMBER OF YEARS:______________________________________________________________________________

RENT/MORTGAGE PAYMENT:__________________________________________________________________________

I certify that the above information is correct and I authorize E Choice Auto Sales and its affiliates to obtain consumer credit reports on me.

___________________________________

Buyer's Signature