Complete the information below to help us qualify you online!!!
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Your First Name:
Your Middle Name:
Your Last Name:
Your SSN:
Date of Birth:
Your Street Address:
Your City, State, & Zip:
Years At This Address:
Your Rent/Mtg Pymt:
Your Home Phone:
Your Employer:
Your Work Address:
Your Title:
Years On Job:
Your Work Phone:
Your Cell Phone:
Your E-mail Address:
Gross Monthly  Income:
Alimony, Child Support, or Seperate Maintenance need not be revealed if you do not wish to have it
considered as a basis for repaying this loan.
Other Income:
Your Trade:
Additional Comments:
Your Initials:
By placing your initials in this box, you are giving City-to-City Auto Sales,
LLC & its affiliates permission to retrieve your credit score and history..
By submitting this application, you promise that all information is true and complete.  You intend
the seller and/or assignee to rely squarely upon these promises in deciding whether to extend
credit to you and authorize a full investigation of your credit and employment history.  You
understand that this application is for the extension of credit, secured by the goods/services
being purchased.  Additional information may be required and subsequent consumer reports may
be requested or utilized in connection with an update, renewal or extension of credit.
City to City Auto Sales, LLC.