En EspaƱol
Applicant Information* Required Field
Previous Address
Employment Information
Previous Employment
Co-Applicant Information
Same as Applicant
Co-Applicant Previous Address
Co-Applicant Employment Information
Co-Applicant Previous Employment
Our Commitment to Privacy
Your privacy is important to us. To view the categories of personal information we collect and the purposes for which the information is used, or to exercise your rights under the California Consumer Privacy Act (CCPA), visit our Privacy Policy.
Acknowledgement and Consent
By clicking the "I Agree / Submit" button and providing an electronic signature below, you are confirming you have read and understood the Financial Privacy Notice and the Application Disclosure, and you certify that all the representations contained in this application are true and correct.

You hereby authorize Galpin Mazda and financial institutions to whom we submit your application (hereinafter "Financial Institutions") to obtain consumer credit reports and to gather credit and employment history and verify income as necessary and appropriate to determine your creditworthiness. You also authorize them to provide credit information concerning this transaction to others. You understand that we will retain this application whether or not it is approved, and that it is your responsibility to notify the creditor of any changes of name, address or employment. You understand that you may be required to provide proof of the representations made by you in this application or through other forms or communications and as such you may be required to provide additional documentation which includes but is not limited to W-2's, Income Tax Returns, Utility Bills, Financial Statements and Pay Check Stubs. You agree to voluntarily provide, upon request of seller or seller's assignee, such additional documentation and understand that your failure to do so may result in an extension of credit being refused.

Financial Institutions may be requested to purchase a sales finance/lease contract written or to be written, in connection with your purchase/lease. You are notified pursuant to the Fair Credit Reporting Act, that your application may be submitted to them.
1111A9
I Agree / Submit
Powered By Informativ