Credit Application | Orange Coast Fleet Chrysler Jeep Dodge

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Credit Application click here for our Commercial Credit Application

1st Applicant
s
Last Name	First Name	Initial

Address	City	State

Zip Code	Home Phone Number	Birth Date

Social Security Number	Drivers License Number

Time at Residence	Monthly Payment	Own / Rent

Employer	Occupation	Employer Phone

Time at Job	Monthly Income

Email

Personal Friends Known Over 1 Year	Friend's Phone Numbers



Vehicle Insurance Information
Insurance Company	Policy Number	Expiration Date

Agent Name


2nd Applicant

Last Name	First Name	Initial

Address	City	State

Social Security Number	Drivers License	Birth Date

Time at Residence

Employer	Occupation	Employer Phone

Time at Job	Monthly Income

Type of vehicle you're interested in	Amount you wish to finance / lease	How did find us?

Comments


Orange Coast - Fleet Sales Privacy Statement
By explaining our privacy policy to you we (the Dealership) trust that this notice will allow you to better understand how we keep certain information private and secure while using it to serve you better. This notice is provided to you as required by the federal Financial Privacy Law and refers to our policies and practices effective on and after July 1, 2001. The notice explains the following: • Protecting the Confidentiality and Security of Consumer Information • Who is Covered by the Privacy Policy; Revisions to the Policy The Types of Information We Have About You and Where It Comes From • Sharing Information with Affiliated Companies • Sharing Information for Legal, Business, and Joint Marketing Purposes. PROTECTING CONFIDENTIALITY AND SECURITY OF CONSUMER INFORMATION We take seriously our responsibility to respect the confidentiality and security of nonpublic personal information - called "Consumer Information" in this notice. Our policy calls for safeguards to protect Consumer Information from unauthorized access, alteration and destruction. For example, our policies authorize access to Consumer Information only by those who need access to do their work. The same holds true for our affiliated companies, which are companies that, now or in the future, we own (or control), or are owned (or controlled) by, or are under common ownership (or control) with. We also may maintain, as required by applicable federal regulations, physical, electronic, and procedural safeguards to guard your nonpublic personal information. WHO IS COVERED BY THE PRIVACY POLICY; REVISIONS TO THE POLICY Our privacy policy applies to individuals (and their legal representatives) who are our consumers or customers in connection with financial services primarily for personal, family, or household purposes, such as leases, installment purchases of vehicles, and insurance. It covers both current and former customers and treats them the same. This notice also describes the privacy policy of our affiliated companies, except as stated in separate notices they give you. Consumers who transact financial services business with the Dealership through the Internet may also be covered by privacy policies that may be posted on the web sites they visit. Individuals who transact business with us but who do not seek financial services from us are not covered by our privacy policy or this notice. We reserve the option of revising this notice and our privacy policy from time to time, but we will give you notice of the revised policy before disclosing Consumer Information about you other than as described in this notice. INFORMATION WE COLLECT We collect and use information about you from various sources. The amount and nature of the information collected and used varies from transaction to transaction, but the information can include the information described in the following five types: 1. Information from you. Information you provide to us on applications, other forms, and by other means, such as your name, address, social security number, assets, income, and debt; 2. Information from our experience and our affiliated companies' experiences. Information about your transactions and account experience with us or our affiliated companies, such as parties to transactions, contract or lease balances, payment history, and communications and correspondence; 3. Information from the experience of other parties. Information from other outside sources regarding their employment, credit or other relationships, account experience, or transactions with you, or verifying representations made by you, such as your employment history, credit balances, or your property or liability insurance coverage.
By clicking on the Submit button, you are stating that you have read and fully understand the Orange Coast Fleet Sales Credit Application privacy policy.