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: By signing below (original or photocopy), I/we are giving RAC authorization to verify our credit and employment, and to use our personal information for collection purposes, notification, and advertisement, however, the personal information shall not be divulged to any other parties aside from the RAC Group of Companies or as required by law. Please give RAC credit information, income, date of hire, and position held by us with you. The parties to this contract agree that in the event that either party files a lawsuit in connection with this contract that venue shall be in Los Angeles County, California, specifically the Citrus Branch Court.