Signature of Applicant Date Signature of Joint Applicant Date

PLAZA AUTO LEASING

2750NOSTRAND AVE

BROOKLYN NY 11210

718-975-9000

718-301-9490 FAX PERSONAL CREDIT APPLICATION
DATE:
_X_INDIVIDUAL APPLICATION __ JOINT APPLICATION
APPLICANT (PRINCIPAL DRIVER OF VEHICLE) / (MARRIED MAY APPLY AS AN INDIVIDUAL)
JOINT APPLICANTRELATIONSHIP
FIRST NAME MI LAST / FIRST NAME MI LAST
DATE OF BIRTH / AGE / SOCIAL SECURITY NUMBER / DATE OF BIRTH / AGE / SOCIAL SECURITY NUMBER
STREET ADDRESS APT# / HOW LONG? / STREET ADDRESS APT# / HOW LONG?
YRS / YRS
CITY / STATE / ZIP / HOME PHONE / CITY / STATE / ZIP / HOME PHONE
PREVIOUS ADDRESS / HOW LONG? / PREVIOUS ADDRESS / HOW LONG?
YRS / YRS
CITY / STATE / ZIP / D.L.# STATE / CITY / STATE / ZIP / D.L.# STATE
___OWN/BUYING __LIVE WITH RELATIVES
_ RENT/LEASE ___OTHER______ / MONTHLY PMT / _ OWN/BUYING ___LIVE WITH RELATIVES
_ RENT/LEASE ___OTHER______ / MONTHLY PMT
$
MORTGAGE CO OR LANDLORD / MORT. AMT / MORTGAGE CO OR LANDLORD / RENT PER MO
$ / $
BANK NAME BRANCH / ACCOUNT# / BANK NAME BRANCH / ACCOUNT#

E

M
P
L
O
Y
M
E
N
T / EMPLOYER NAME / HOW LONG? / EMPLOYER NAME / HOW LONG?
YRS / YRS
EMPLOYER ADDRESS / EMPLOYER ADDRESS

POSITION/TITLE

/ WORK PHONE / GROSS INCOME / POSITION/TITLE / WORK PHONE / GROSS INCOME
$ / $
OTHER INCOME SOURCE / ANNUAL AMT / OTHER INCOME SOURCE / ANNUAL AMT
$ / $
PREVIOUS EMPLOYER OR SCHOOL / HOW LONG? / PREVIOUS EMPLOYER OR SCHOOL / HOW LONG?
YRS

R

E
F
E
R
E
N
C
E
S / AUTO CREDIT REFERENCES / TRADING / BALANCE / AUTO CREDIT REFERENCES / TRADING / BALANCE
$ / $
OTHER CREDIT REFERENCES / BALANCE / OTHER CREDIT REFERENCES / BALANCE
$ / $
NEAREST RELATIVE (NOT LIVING WITH YOU) / RELATIONSHIP / NEAREST RELATIVE (NOT LIVING WITH YOU) / RELATIONSHIP
ADDRESS / PHONE / ADDRESS / PHONE
FRIEND OR RELATIVE / PHONE / FRIEND OR RELATIVE / PHONE
S
I
G
N / NOTICE: THE APPLICANT HAS THE RESPONSIBILITY TO NOTIFY PLAZA AUTO LEASING WITHIN A REASONABLE TIME OF ANY CHANGE IN THE APPLICANT’S NAME, ADDRESS OR EMPLOYMENT. INSURANCE RELATED TO THE CREDIT FOR WHICH YOU ARE APPLYING MAY BE PURCHASED FROM AN INSURER OR AGENT OF YOUR CHOICE WHO MEETS OUR STANDARDS. EVERYTHING THAT I HAVE STATED IN THIS APPLICATION IS CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT YOU WILL RETAIN THIS APPLICATION WHETHER OR NOT IT IS APPROVED. YOU ARE AUTHORIZED TO CHECK MY CREDIT AND EMPLOYMENT HISTORY AND TO ANSWER QUESTIONS ABOUT YOU CREDIT EXPERIENCE WITH ME. (IN CONNECTION WITH YOUR APPLICATION FOR CREDIT, A CONSUMER REPORT MAY BE REQUESTED. ON YOUR REQUEST WE WILL ADVISE YOU IF THE REPORT WAS ACTUALLY ORDERED AND IF SO, THE NAME AND ADDRESS OF THE AGENCY THAT FURNISHED THE REPORT. SUBSEQUENT CONSUMER REPORTS MAY BE ORDERED.)
______

SIGNATURE OF APPLICANT DATE SIGNATURE OF JOINT APPLICANT DATE