2644 South Main St
Mt Airy, NC 27030
336-368-1999
Site Menu
Inventory
Financing
Apply Online
Loan Calculator
Visit Us
Services
Value Your Trade-In
Vehicle Finder
Our Store
About Us
Contact Us
Meet Our Staff
Testimonials
Privacy Policy
APPLY FOR CREDIT
Applicant Information
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Social Security:
Date of Birth:
Drivers License Number:
Drivers License State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Drivers License Exp:
Mobile Phone:
Home Phone:
Email:
Time at Residence:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Residence Type:
Rent
Own
Living with Family
Military Housing
Other
Rent/Mortgage:
Applicant Employment Information
Employer:
Monthly Income:
Occupation:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Work Phone:
Time on Job:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Do you have a co-buyer?
Add Co-Buyer
Remove Co-Buyer
Co-Buyer Information
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Social Security:
Date of Birth:
Drivers License Number:
Drivers License State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Drivers License Exp:
Mobile Phone:
Home Phone:
Email:
Time at Residence:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Residence Type:
Rent
Own
Living with Family
Military Housing
Other
Rent/Mortgage:
Co-Buyer Employment Information
Employer:
Monthly Income:
Occupation:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Work Phone:
Time on Job:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Vehicle Information
Vehicle To Finance:
Select Vehicle to Finance
2016 EZGO Golf Cart Carolina Panthers Custom Black Select Select Select Golf Cart Select 19-553 0 Cylinders - 19-553
2014 GMC Sierra 1500 SLE2 Ext. Cab 4WD Red 4WD Cloth Automatic Truck 5.3L V8 OHV 16V Gasoline 20-092 8 Cylinders - 20-092
2013 Toyota Avalon Limited White FWD Leather Automatic Sedan 3.5L V6 DOHC 24V Gasoline 21-016 6 Cylinders - 21-016
2013 Fleetwood Bounder Classic M 36R Burgundy Leather Automatic Class A Motorhome Gasoline 20-700 10 Cylinders - 20-700
2011 Chevrolet Tahoe LTZ 4WD White 4WD Leather Automatic SUV 5.3L V8 OHV 16V FFV Gasoline 21-026 8 Cylinders - 21-026
2010 Honda Civic EX Coupe 5-Speed AT Gray FWD Cloth Automatic Coupe 1.8L L4 SOHC 16V Gasoline 21-027 4 Cylinders - 21-027
2006 Harley-Davidson FLSTCI Heritage Softail Classic Black Select Select Select Motorcycle 1450CC 21-021 0 Cylinders - 21-021
2006 Ford Mustang S281 Saleen Convertible Red Leather Automatic Convertible 4.6L V8 SOHC 24V Gasoline 21-501 8 Cylinders - 21-501
2005 Ford F-650 SuperCab 2WD DRW White 2WD Cloth Automatic Roll Back Cummins Diesel Diesel 21-508 0 Cylinders - 21-508
2005 Chevrolet Silverado 2500HD Work Truck Ext. Cab Short Bed 4WD Pewter 4WD Cloth Manual Truck 6.0L V8 OHV 16V Gasoline 21-029 8 Cylinders - 21-029
2003 Chevrolet Blazer 2-Door 2WD LS Red 2WD Cloth 5 Speed SUV 4.3L V6 OHV 12V Gasoline 20-094 6 Cylinders - 20-094
2002 Chevrolet Malibu Base Burgundy Cloth Automatic Sedan 3.1L V6 OHV 12V 21-507 6 Cylinders - 21-507
2001 Chevrolet Silverado 1500 Ext. Cab Short Bed 2WD Burgundy 2WD Cloth Automatic Truck 5.3L V8 OHV 16V Gasoline 21-028 8 Cylinders - 21-028
1979 Chevrolet Camaro 2dr Coupe Z28 Black Vinyl Automatic Classic Car Select Gasoline 21-503 8 Cylinders - 21-503
1972 Ford LTD Yellow Select Cloth Automatic Classic Car Select Gasoline 21-504 8 Cylinders - 21-504
Stock Number:
Year:
Make:
Model:
Trim:
Vin:
Mileage:
Additional Comments
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.
ACKNOWLEDGMENT AND CONSENT:
I hereby consent to receive text messages or phone calls from or on behalf of the dealer or their employees to the mobile phone number I provided above. By opting in, I understand that message and data rates may apply. This acknowledgement constitutes my written consent to receive text messages to my cell phone and phone calls, including communications sent using an auto-dialer or pre-recorded message. You may withdraw your consent at any time by texting "STOP".
Submit Credit App