Apply for Financing

We at Herb Connolly want to thank you for your financing request. Our goal is to offer you, our future customer with the best financing available. You look forward to earning your business. Feel free to Contact our Financing Manager anytime at:

ACKNOWLEDGMENT AND CONSENT: I certify that the above information is complete and accurate to the best of my 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 me to criminal penalties. I authorize the creditors to obtain credit reports about me on an ongoing basis during this credit transaction and to check my credit and employment history on an ongoing basis during the term of the credit transaction. If this application is approved, I authorize the creditor to give credit information about me to its affiliates.

If you're a resident of California, Maine, Massachusetts, New York, Ohio, Rhode Island, Vermont, Washington, or Wisconsin, please scroll down to read the notice called for under the law of your state. By submitting this application, you represent that you've read the notice required under the law of your state.

CALIFORNIA RESIDENTS: A married applicant may apply for an individual account.

MAINE RESIDENTS: Consumer reports (credit reports) may be obtained in connection with this application.

If you request, the creditor will inform you: (1) whether or not consumer reports were obtained, and (2) if reports were obtained, the names and addresses of the consumer reporting agencies (credit bureaus) that furnished the reports. You have the right to choose the agent and insurer for the insurance required by this transaction, but the insurer must be approved by the creditor.

MASSACHUSETTS RESIDENTS: Massachusetts law prohibits discrimination on the basis of marital status or sexual orientation.

NEW YORK RESIDENTS: A consumer credit report may be requested in connection with this application or in connection with updates, renewals, extensions or enforcement of any credit granted as a result of this application. Upon your request, the creditor will inform you whether or not a consumer credit report was requested, and if so, the name and address of the agency that furnished such report.

OHIO RESIDENTS: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

RHODE ISLAND RESIDENTS: A consumer credit report may be requested in connection with this application.

VERMONT RESIDENTS: I authorize the creditor to obtain credit reports on an ongoing basis about me from credit reporting agencies in connection with this extension of credit transaction. The creditor may obtain credit reports about me on an ongoing basis in connection with this extension of credit transaction for any one or more of the following reasons: (1) reviewing the account; (2) increasing the credit line on the account; (3) taking collection action on the account; or, (4) any other legitimate purposes associated with the account.

WASHINGTON RESIDENTS: Please advise us if the creditor should investigate your credit references and/or credit history under another name.

MARRIED WISCONSIN RESIDENTS: No provision of a marital property agreement, a unilateral settlement agreement under Wis. Stat. §766.59, or a court decree under Wis. Stat. §766.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree, or has actual knowledge of the adverse provision.

PRIVACY AGREEMENT

In connection with your transaction, Herb Connolly, may obtain information about you as described in this notice, which we handle as stated in this notice.

1. We collect nonpublic personal information about you from the following sources: information we receive from you on applications or other forms; information about your transactions with us, our affiliates or others; and, information we receive from a consumer reporting agency.

2. We may disclose all of the information that we collect about you as described above, while you are a consumer, customer, or former customer, to our affiliates and to non-affiliated third parties.

3. We may disclose nonpublic personal information about you, while you are a consumer, customer, or former customer, to the following types of third parties: financial service providers, such as banks, captive financial companies, credit unions, and financial institutions; non-financial companies, such as auto manufacturers, market research firms, etc..

4. We may also disclose nonpublic personal information about you to nonaffiliated third parties as permitted by law.

5. If you prefer that we not disclose nonpublic personal information about you to nonaffiliated third parties, you may opt out of those disclosures; that is, you may direct us not to make those disclosures (other than disclosures permitted by law). Please check the box below if you wish to opt out of disclosures to nonaffiliated third parties, and return the top copy to this dealership at the address provided above.

6. We may disclose, while you are a consumer, customer, or former customer, any information we collect about you to companies that perform marketing services on our behalf or to other financial institutions with whom we have joint marketing agreements. This disclosure is permitted by law; there is no opt-out opportunity available.

7. We may disclose nonpublic personal information about you, while you are a consumer, customer, or former customer, to the following types of affiliates:

8. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

CREDIT APPLICATION
FIRST NAME
MIDDLE INITIAL
LAST NAME
BIRTHDATE
SS#
EMAIL
PHONE	Format: XXX-XXX-XXXX
COMMENTS
RESIDENCE TYPE	Own Rent
HOME ADDRESS
LINE 2	(OPTIONAL)
CITY
STATE
ZIP
AT RESIDENCE SINCE
PAYMENT	$ PER MONTH
PREVIOUS RESIDENCE
If you have been at your current residence for less than 2 years. Please enter your previous address below:
HOME ADDRESS
LINE 2	(OPTIONAL)
CITY
STATE
ZIP
MOVE-IN DATE

BANKRUPTCY?	Have you filed bankruptcy in the last two years? Yes No
NEGATIVE CREDIT?	Have you had any known negative blemishes on your credit in the past 6 months? Yes No
PLEASE EXPLAIN

SIMILAR VEHICLE?	Pre-Qualify for a loan on a similar car if this vehicle is not available? Yes No
TYPE OF FINANCING	Buy Lease
LOAN TERM	MONTHS
LOAN AMOUNT	$
DOWN PAYMENT	$ (NOT including optional trade-in)
TRADE-IN
DO YOU HAVE A TRADE-IN?	Yes No

TRADE-IN VEHICLE

ESTIMATED PAY-OFF	$
VEHICLE CONDITION
DESCRIPTION
OCCUPATION
OCCUPATION
EMPLOYER NAME
EMPLOYER ADDRESS
CITY
STATE
ZIP
EMPLOYER PHONE
DATE STARTED
MONTHLY INCOME	$ PER MONTH FROM EMPLOYER (GROSS)
OTHER INCOME	$ PER MONTH (GROSS)
TOTAL INCOME	$ PER MONTH (GROSS)
If you have been with your current employer for less than 2 years. Please enter your previous employer information below:
EMPLOYER NAME
EMPLOYER ADDRESS
CITY
STATE
ZIP
EMPLOYER PHONE
DATE STARTED
AGREEMENT
We at Herb Connolly want to thank you for your financing request. Our goal is to offer you, our future customer with the best financing available. You look forward to earning your business. Feel free to Contact our Financing Manager anytime at: ACKNOWLEDGMENT AND CONSENT: I certify that the above information is complete and accurate to the best of my 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 me to criminal penalties. I authorize the creditors to obtain credit reports about me on an ongoing basis during this credit transaction and to check my credit and employment history on an ongoing basis during the term of the credit transaction. If this application is approved, I authorize the creditor to give credit information about me to its affiliates. If you're a resident of California, Maine, Massachusetts, New York, Ohio, Rhode Island, Vermont, Washington, or Wisconsin, please scroll down to read the notice called for under the law of your state. By submitting this application, you represent that you've read the notice required under the law of your state. CALIFORNIA RESIDENTS: A married applicant may apply for an individual account. MAINE RESIDENTS: Consumer reports (credit reports) may be obtained in connection with this application. If you request, the creditor will inform you: (1) whether or not consumer reports were obtained, and (2) if reports were obtained, the names and addresses of the consumer reporting agencies (credit bureaus) that furnished the reports. You have the right to choose the agent and insurer for the insurance required by this transaction, but the insurer must be approved by the creditor. MASSACHUSETTS RESIDENTS: Massachusetts law prohibits discrimination on the basis of marital status or sexual orientation. NEW YORK RESIDENTS: A consumer credit report may be requested in connection with this application or in connection with updates, renewals, extensions or enforcement of any credit granted as a result of this application. Upon your request, the creditor will inform you whether or not a consumer credit report was requested, and if so, the name and address of the agency that furnished such report. OHIO RESIDENTS: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law. RHODE ISLAND RESIDENTS: A consumer credit report may be requested in connection with this application. VERMONT RESIDENTS: I authorize the creditor to obtain credit reports on an ongoing basis about me from credit reporting agencies in connection with this extension of credit transaction. The creditor may obtain credit reports about me on an ongoing basis in connection with this extension of credit transaction for any one or more of the following reasons: (1) reviewing the account; (2) increasing the credit line on the account; (3) taking collection action on the account; or, (4) any other legitimate purposes associated with the account. WASHINGTON RESIDENTS: Please advise us if the creditor should investigate your credit references and/or credit history under another name. MARRIED WISCONSIN RESIDENTS: No provision of a marital property agreement, a unilateral settlement agreement under Wis. Stat. §766.59, or a court decree under Wis. Stat. §766.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree, or has actual knowledge of the adverse provision. PRIVACY AGREEMENT In connection with your transaction, Herb Connolly, may obtain information about you as described in this notice, which we handle as stated in this notice. 1. We collect nonpublic personal information about you from the following sources: information we receive from you on applications or other forms; information about your transactions with us, our affiliates or others; and, information we receive from a consumer reporting agency. 2. We may disclose all of the information that we collect about you as described above, while you are a consumer, customer, or former customer, to our affiliates and to non-affiliated third parties. 3. We may disclose nonpublic personal information about you, while you are a consumer, customer, or former customer, to the following types of third parties: financial service providers, such as banks, captive financial companies, credit unions, and financial institutions; non-financial companies, such as auto manufacturers, market research firms, etc.. 4. We may also disclose nonpublic personal information about you to nonaffiliated third parties as permitted by law. 5. If you prefer that we not disclose nonpublic personal information about you to nonaffiliated third parties, you may opt out of those disclosures; that is, you may direct us not to make those disclosures (other than disclosures permitted by law). Please check the box below if you wish to opt out of disclosures to nonaffiliated third parties, and return the top copy to this dealership at the address provided above. 6. We may disclose, while you are a consumer, customer, or former customer, any information we collect about you to companies that perform marketing services on our behalf or to other financial institutions with whom we have joint marketing agreements. This disclosure is permitted by law; there is no opt-out opportunity available. 7. We may disclose nonpublic personal information about you, while you are a consumer, customer, or former customer, to the following types of affiliates: 8. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.
	I do not want my information disclosed to nonaffiliated third parties. Yes, I agree to the Terms and Privacy Statement above.

CREDIT APPLICATION