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Primary Applicant
*Application Type Single    Joint

Contact Information
*First Name: *Last Name:
*EMail: Home Phone:
*Day Phone: Fax:
Cell Phone: *Preferred Contact:
Addesss: City:
State: Zip:

Personal Information
*Social Security #:
- -
*Date of Birth:
*Do you own or rent? Own    Rent
*Monthly Mort/Rent Payment?
*How long at this address?
*Employer:
*Occupation:
*Employement Duration:  Years   Months
*Gross Monthly Income:
*Previous Employer:
*Employement Duration:  Years   Months

Other Information
Cash Down Payment:
Trade In:
Balanced Owed:
I'm looking to:

In connection with this credit application, Performance Auto Sales may receive information about you as outlined below, which we handle as stated below.
   1. Nonpublic personal information may be collected about you from the following sources:
       - Information received from you on applications or other forms;
       - Information about your transactions with us; and
       - Information received from a consumer reporting agency.
   2. Performance Auto Sales will not disclose nor will we reserve the right to disclose, any nonpublic personal information about our consumers, customers or former customers to anyone, except as permitted by law. Performance Auto Sales may disclose nonpublic personal information about you, as a consumer, customer or former customer, to non-affiliated third parties as permitted by law.
   3. Performance Auto Sales restrict access to nonpublic personal information about you to employees who need to provide products or services to you. Performance Auto Sales maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.
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By filling in my complete name as listed above, I give my authorization to begin a credit investigation based on the information voluntarily provided by me. This information is true and correct. I understand that as part of the credit investigation a credit report may be obtained. Upon request, I will be told if a credit report(s) was/were obtained, and given the name and address of the credit reporting agency(s) providing the report(s).

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Performance Auto Sales - Automotive Web Site Demo
Kennewick, WA 99336
Ph: 509 586-6539
Email: ocs@online-cs.net
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