Majestic Auto Leasing & Sales » Submit An Individual Application

APPLICANT - PERSONAL INFORMATION

(PRINCIPAL DRIVER OF VEHICLE)

First Name *

Middle Initial

Last Name *

Date of Birth *

SS Number *

Home Phone *

Street Address *

City *

State *

Zip *

How many years at address? *

How many Months?

If less than 3 years.

Own or Rent? *

Own/Buying

Rent/Lease

Monthly Payment *

Previous Address

If at current address less than 3 years

Street Address

City

State

Zip

APPLICANT - EMPLOYMENT

Employer Name *

Self if Self Employed

Position/Title *

How many years employed? *

How many Months?

If less than 3 years.

Work Phone

Gross Annual Salary *

Other Income Source

Total Annual Income *

Employer Address *

City *

State *

Zip *

Previous Employment

If at current employment is less than 3 years

Previous Employer or School

If current employer is less than 3 years

How many years employed?

How many Months?

If less than 3 years.

E-mail Address

Best Contact Phone

Notes

Privacy Policy

IN CONNECTION WITH YOUR TRANSACTION MAJESTIC AUTO LEASING & SALES, LLC AND ALL ITS AFFILIATES MAY OBTAIN INFORMATION ABOUT YOU AS DESCRIBED IN THIS NOTICE.

1. WE COLLECT NONPUBLIC PERSONAL INFORMATION ABOUT YOU FROM THE FOLLOWING SOURCES:

*  INFORMATION WE RECEIVED FROM YOU ON APPLICATIONS OR OTHER FORMS

*  INFORMATION ABOUT YOUR TRANSACTIONS WITH US, OUR AFFILIATES OR OTHERS, AND

*  INFORMATION WE RECEIVE FROM A CONSUMER AGENCY

2. WE DISCLOSE ALL OF THE INFORMATION WE COLLECT AS DESCRIBED ABOVE TO COMPANIES THAT PERFORM MARKETING SERVICES ON OUR BEHALF OR TO OTHER FINANCIAL INSTITUTIONS WITH WHOM WE HAVE JOINT MARKETING AGREEMENTS. WE MAKE SUCH DISCLOSURES ABOUT YOU AS A CONSUMER, CUSTOMER, OR FORMER CUSTOMER.

3.  WE MAY DISCLOSE NONPUBLIC PERSONAL INFORMATION ABOUT YOU AS A CONSUMER, CUSTOMER, OR FORMER CUSTOMER TO NON-AFFILIATED THIRD PARTIES AS PERMITTED BY LAW.

4.  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 OR GAURD YOUR NONPUBLIC PERSONAL INFORMATION.

I, THE UNDERSIGNED, HEREBY AUTHORIZE MAJESTIC AUTO LEASING & SALES, LLC AND ITS AFFILIATES (COLLECTIVELY "PROSPECTIVE CREDITORS") TO VERIFY CREDIT AND EMPLOYMENT HISTORY AS STATED ABOVE AND TO ANSWER QUESTIONS ABOUT CREDIT EXPERIENCE WITH ME. IF THIS APPLICATION IS MADE PURSUANT TO ANY CREDIT PROGRAM FOR ATTENDEES AND/OR GRADUATES OF SCHOOLS OR EDUCATIONAL INSTITUTION (S), THEN PROSPECTIVE CREDITORS MAY VERIFY MY ELIGIBILITY FOR SUCH PROGRAM, INCLUDING BY INQUIRY TO MY SCHOOL (S) OR EDUCATIONAL INSTITUTION (S). INSURANCE RELATED TO THE CREDIT FOR WHICH I AM APPLYING MAY BE PURCHASED FROM AN INSURER OR AGENT OF MY CHOICE WHO MEETS PROSPECTIVE CREDITOR STANDARDS. IN CONNECTION WITH THIS APPLICATION FOR CREDIT, PROSPECTIVE CREDITORS MAY REQUEST A CONSUMER (CREDIT) REPORT.

I AUTHORIZE PRSPECTIVE CREDITORS TO ASK MY PAST AND CURRENT CREDITORS ("CREDIT REFERENCES"), INCLUDING CREDITORS LISTED ABOVE OR ON MY CONSUMER (CREDIT) REPORT, ABOUT MY CREDIT PERFORMANCE WITH THEM. PROVISION BY PROSPECTIVE CREDITORS OF A COPY OF THIS AUTHORIZATION SHALL SERVE AS MY DIRECTION THAT CREDIT REFERENCES PROVIDE MY CREDIT PERFORMANCE INFORMATION.

EVERYTHING THAT I HAVE STATED IN THIS APPLICATION IS CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT PROSPECTIVE CREDITORS WILL RETAIN THIS APPLICATION WHETHER OR NOT IT IS APPROVED. I WILL NOTIFY PROSPECTIVE CREDITORS, IF APPLICABLE, WITHIN A REASONABLE AMOUNT OF TIME OF ANY CHANGE IN MY NAME, ADDRESS, OR EMPLOYMENT.

CUSTOMER ACKNOWLEDGEMENT *

I (we) acknowledge that I (we) received a copy of this notice and agree to the terms and conditions set forth on the data indicated below.

Electronic Signature *

Submit An Individual Application

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