Vehicle Loan Application Form for Printing / Faxing
VEHICLE LIQUIDATION
8719 E Pearblossom Hwy Littlerock, CA 93543
Phone: (661) 944-9300 Fax: (661) 944-9500

If you have any problems with this online form, please call us at (661) 944-9300 and ask for the finance department. They will be able to assist you successfully.

Fax a copy of this form to our office at (661) 944-9500 or bring a copy with you.

NOTE: Once all the items marked with an asterisk (*) are filled in, click the "Print This Page" button at the bottom and your Printer window will open. Then click Print.
Personal Information
*Name:
*Email:
*Address:
 
*City:
*State:
*Zip:
*Years Resided:
*Home Phone:
*Date of Birth:
*Driver's License Number:
*Social Security Number:
*Employer's Name:
*Employer's Address:
*Your Position:
*Length of Employment:
*Employer's Phone:
Wage or Salary:
*Per Week: $
*Monthly Income: $
Other Income:
Previous Employer:
Previous Length of Employment
Print Page Break
*Nearest Relative Not Living With You:
*Their Address:
*Their Phone:
Financial Status:
*Total Monthly Income: $
*Monthly Expenses: $
* = Disposable Income: $
Loan Amount Requested:
Length of Loan (# of Months):
Monthly Payment Desired:
References:
List bank, major companies or stores where you have had credit in the past:
*Bank Checking:
Bank Savings:
Major Credit Cards:
Major Credit Cards:
 

Everything I have stated in this application is correct to the best of my knowledge. I understand that Vehicle Liquidation will retain this application whether or not it is approved. I authorize Vehicle Liquidation to check my credit and employment history. I also acknowledge that this does not constitute an agreement for, or gaurantee that I will receive, any type of loan that I am applying for.

I Agree* 

By submitting this form, you certify that the information provided is complete and accurate to the best of your knowledge. Creditors receiving this application will retain the application whether or not it is approved. Creditors may rely on this application in deciding whether to grant the requested credit. False statements may subject you to criminal penalties. You authorize the creditors to obtain credit reports about you on an ongoing basis during this credit transaction and to check your credit and employment history on an ongoing basis during the term of the credit transaction. If this application is approved, you authorize Vehicle Liquidation to give credit information about you to its affiliates.