image
Call Steve Tenwick at (702) 546-5626 or complete this form.

If you are shopping for a vehicle, we want to help you!

ALL INFORMATION IS KEPT CONFIDENTIAL AND USED SOLELY FOR THE PURPOSE OF OBTAINING AN AUTOLOAN

  First Name   Last Name   Jr.
 Sr.
     
           
  Date of Birth   Social Security   Drivers License Number
     
           
  Home Phone   Cell Phone eMail Address
   
           
  Current Address      
   
  City State Zip  
   
       
  Housing Situation: Own Outright  Pay Mortgage Rent  Live with Relatives Other
       
  How Long at Residence?   How Much do you Pay in Rent or Mortgage?
   
       
  Previous Address (If less than 2 years at current address)  
 
  City State Zip
 
             
  Employment          
  Where do you work?       Work Phone  
     
  Job Title / rank Gross Monthly Income   How long on the job?  
     
             
  Previous Employer (If less than 5 years at current job)   How long at previous job?  
     
             
  Do you have a second Income? Yes No   Amount of Second Income  
 

Source of second income:

 
             
  Interest          
 

What Type of Vehicle are you

  Desired

Trade Information:       Do you have a vehicle to trade? Yes   No

If so, What type of vehicle (year/make)

VIN of your trade

Miles on Trade   How much do you owe on your trade? 

 

I authorize this website and its affiliates to check my creditYes No