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Finance Pre-Qualification Form

Bruised Credit is not a problem!

Please Note: Although it is most unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms capable browser) you may email your response to this form to: finance@cityselectauto.com

To avoid form failure, all fields Marked with an " * " MUST be completed.

Personal Information:
*Full Name:
*Current Street Address:
*City:
*State
*Zip:
*Length of Residence:	Years/Months:
Home Phone:
Cellular Phone:
E-Mail:
Full Birthdate:
Social Security #:

Current Employer:
Current Employment Status:	Self Employed Employee Other (describe in "Comments" Below)
Employer Name:
Monthly Income (gross):
Length of Employment:	Years: Months:
Street Address:
City:
State:
Zip Code:
Business Phone:
Trade or Occupation:
*Downpayment Available:

Comments & Additional Information:

I authorize a check to be run on my credit report.
Yes No

I certify that the above information is true and correct to the best of my knowledge:
(Please type your "Full Name" below)
Digital Signature:

Date:

Email: finance@cityselectauto.com

MAIN OFFICE:

Sales & Administrative Services
4375 Route 130 South
Burlington, NJ 08016
Phone:
(609) 877-0005 or (800) 228-CITY (2489)
Fax:
(609) 877-9592

Sales Office & Recon Center
2541 Mt. Ephraim Avenue
Camden, NJ 08104
Phone:
(856) 962-7770 or (800) 858-CITY (2489)