Credit Application Form

    Buyers's Information



    Co-Buyer


    Loan Request

    Option 1
    Option 2
    w/added COX

    Purchase Price

    Down Payment

    Total Amt Fin.

    No. of Months



    * Total Amt. Fin. = New Amt. Fin. + 28 Fee + Prior Bal. Payoff (if applicable)

    Document
    Buyer
    COX

    Pay Stubs

    Picture ID

    Bank Stmt

    Utility Bill

    Tax Rtrn


    References

    Name
    Phone Number
    City
    Relationship

    Nearest Relative:

    Phone Number

    City

    Relationship


    Friend Family:

    Phone Number

    City

    Relationship


    Friend Family:

    Phone Number

    City

    Relationship


    Friend Family:

    Phone Number

    City

    Relationship

    Nearest Relative:

    Friend Family:

    Friend Family:

    Friend Family: