AAMCO Preston

$3000.00 and under

Application for Auto Repair
AAMCO
6309 Preston Highway Louisville KY 40219

*All fields are required for completion of application.

APPLICANT: Please read the following before completing this form. You are applying for individual credit. Married applicants may apply for an individual account.

Individual Credit

APPLICANT MUST: -LIVE WITHIN A 45 MILE RADIUS FROM LOUISVILLE, KY. - Min 1 Year at Employer. - Min 1 Year at Residence. -Have $1,200 minimum income -Must have Established Credit in good standing Please check here to confirm you meet these requirements. *

I agree

Loan Information

* Indicates required field

Amount Requested (AAMCO - Preston Highway) *

Personal Information

Name *

First

Last

Social Security Number *

Date of Birth *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Housing Status *

Mortgage Payment / Rent *

How many years/months at residence?

# of Years *

# of Months *

Home Phone Number *

Cell Phone Number *

By providing my mobile and/or home number, including a number that I later convert to a mobile number, I consent to receive calls, text messages by or on behalf of Jefferson Financial Services, Inc. regarding the processing of my loan application and, if approved, for other transactional purposes, such as the collection and servicing of my account. I understand my consent for non-marketing calls and messages applies to each phone number that I voluntarily provide to Jefferson Financial Services, Inc. now or in the future or obtained by Jefferson Financial Services, Inc. through other lawful means.

Email *

Employment Information

Employers Name *

Employment Type *

Employers Address *

Your Position *

Employers Phone *

How many years/months at employer?

# of Years *

# of Months *

Gross Monthly Income *

Additional Income: Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation. *

Have you filed Bankruptcy in the past? *

Do you pay child support or alimony? *

Are you a Co-Signer on any other loans? *

Do you have any vehicles registered in your name? * *

Year, Make, Model and Miles of Auto #1 *

Year, Make, Model and Miles of Auto #2 *

Comment *

By submitting this Loan Inquiry Form, I/We acknowledge and certify for the purpose of obtaining credit from you and with the intent that you will rely heron and to induce you to extend said credit, that the information given herein is complete, true and correct and at this time I/We fully realize that you are relying upon this to extend credit to me/us. The applicant expressly authorizes Jefferson Financial Services to make inquiries of others concerning the foregoing information and to provide information arising out of the applicant's transactions with you to others. Any person or entity named herein is expressly authorized to furnish you with information in connection with this application. Your Social Security Number is required so we can access your credit report and shorten the approval process. *

I Agree

All loans are subject to our normal credit requirements and may be subject to the provision of acceptable collateral for the loan. All loans must be closed in the office located at 5618 Bardstown Road Louisville, KY. If you have an existing account with Jefferson Financial Services Inc., it will be refinanced and any unearned interest will be rebated in accordance with your original loan agreement.

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