Business Credit Application

Thank you for taking the time to fill out a credit application for Ruxer Fleet. Be assured that the information you submit is kept secure and confidential.

* Indicates a required field.

Preferred Salesman:
What is the vehicle you are interested in:
Trim (if known):
Primary Applicant: Personal Information
First Name: *
Middle Initial: *
Last Name: *
Address: *
City: *
State: *
Zip: *
Time at Residence:* Years:  Months: 
Phone: *
E-mail: *
Date of Birth: * Month:  Day:  Year: 
Social Security Number: *
Driver’s License Number: * State: * 
Dwelling Information
Please Check Oneof the Following:
  • Own Home Outright
  • Buying Home
  • Living with Relatives
  • Leasing/Renting
  • Own/Buying Mobile Home
Name of Landlord orMortgage Holder:
Address of Landlord orMortgage Holder:
Rent or MortgagePayment:
Education Information
Education Level:
  • Four Year College Degree or Higher
  • Two Year College Degree
  • Special Training or Trade School
  • Some College
  • High School Graduate
Employer Information
Your Current Employer:
Your Position:
Time on Job: Years:  Months: 
Gross Annual Income: Before Taxes
Other Income:
Source of Other Income:
Banking Information
Name of Bank:
Please CheckAll that Apply:
  • Checking & Savings
  • Checking Only
  • Savings Only
  • Other
  • None
Do You Have Any Current Auto Loans? Yes  No
Name of Creditor:
Current Unpaid Balance:
Have You Had Any Previous Auto Loans: Yes  No
Name of Creditor:
Date Opened:
Monthly Payment Amount:
Amount Borrowed:
Date Closed:
Have You Ever Had a Car or Other Merchandise Repossessed? Yes  No
If Yes, Date of Repossession:
Have You Ever Had a Bankruptcy? Yes  No
Has the Bankruptcy been Discharged? Yes  No
If Yes, Date of Discharge:
Fair Credit Reporting Act Disclosure
Privacy Notice
By clicking Submit you agree to the above statement and allow Ruxer Ford Lincoln to check your credit. If you choose not to please click on No Thanks.
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