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Finance Application

This is NOT a secure page and is NOT an online application.

You may fill in the form online but please PRINT the application and bring it with you or fax it to us at 978-369-4759

 


Auto Loan Request

Amount Requested:
Type of Application: Individual Applicant Joint Applicant
Term Requested:
24 mos. 36 mos. 48 mos. 60 mos. Other
Year of Vehicle
 Make
 Model
Purchase Price
 Down Payment
 Finance Amount
Dealer Name:   CONCORD AUTO SALES AND SERVICE INC.
Trade-In Yes No Creditor of Trade-In


Applicant

First Name
 Middle Initial
 Last Name
Date of Birth
 Social Security No.
 No. of Dependents
Driver's License No.
 Driver's License State
 Your E-mail Address
Home Phone
 Best Time To Call
 Work Phone


Residence

Your Primary Residence:
Own with Mortgage Own Clear Rent Other
Present Street Address
 City
 State
 Zip
Years At Present Address
 Your Monthly Rent or Mortgage Payment
Years At Previous Address
 Your Previous Address


Employment

Employed Self-Employed Retired Unemployed Student
Your Present Employer
 Phone
City
 State
 Zip
Gross Monthly Salary
 Your Positon
 Years There
You do not have to list alimony, child support or separate maintenance income unless you want us to consider it for the purposes of granting and repayment of this credit request.
Other Monthly Income
 Source of Other Income
Previous Employer
(if less than 3 years at current employer)
 Years at
Previous Employer


Additional Information

Name of Your Bank/CU
  


Co-Applicant

First Name
 Middle Initial
 Last Name
Date of Birth
 Social Security No.
 No. of Dependents
Driver's License No.
 Driver's License State
 Your E-mail Address
Home Phone
 Best Time To Call
 Work Phone


Co-Applicant Residence

Your Primary Residence:
Own with Mortgage Own Clear Rent Other
Same as above
Present Street Address
 City
 State
 Zip
Years At Present Address
 Your Monthly Rent or Mortgage Payment
Years At Previous Address
 Your Previous Address


Co-Applicant Employment

Employed Self-Employed Retired Unemployed Student
Your Present Employer
 Phone
Street Address
 City
 State
 Zip
Gross Monthly Salary
 Your Positon
 Years There
You do not have to list alimony, child support or separate maintenance income unless you want us to consider it for the purposes of granting and repayment of this credit request.
Other Monthly Income
 Source of Other Income
Previous Employer
(if less than 3 years at current employer)
 Years at
Previous Employer
Street Address
 City
 State
 Zip


Co-Applicant Additional Information

Name of Your Bank/CU
  


Applicant(s) Statement
I/We have completed this request for credit in consideration of a loan to me and/or others upon my guarantee. I/We certify that all information contained herein is accurate and complete to the best of my knowledge.

I/We authorize you to retain property of this application, to rely on the foregoing, to check and verify my credit, employment and salary history, to secure follow up credit reports concerning my credit worthiness and to exchange information about my account with proper persons, creditors and credit bureaus.

I authorize my employer (present and future), bank and other references listed above to release and/or verify information at any time. I acknowledge that this application is subject to approval of credit and acceptance. Should my request for credit and subsequent loan be approved, I agree to give written notice immediately upon change of my name, address, employment or any other pertinent information contained herein.

      SIGNATURE APPLICANT ______________________________ DATE _______

SIGNATURE CO-APPLICANT _____________________________ DATE _______

 

PRIVACY POLICY

 

 

 

 

Privacy Policy:

Concord Auto Sales and Service Incorporated complies with the requirements of Title V of the Gramm-Leach-Bliley Act, 15 U.S.C. 6801 through 6810 (GLB Act), and the Federal Trade Commissions implementing regulation, Regulation P, 16 C.F.R. Part 313 (Regulation P), in particular, as both relate to the disclosure and protection of Non-Public Personal Information (NPI) for Customers with regard to the authorized distribution and intended use of Customers financial information to other parties. Concord Auto Sales and Service Incorporated will substantially comply with the GLB Act and Regulation P for all Customer NPI received, transferred or obtained from the use of this site or from a party (a party and collectively the parties). In particular, each party may use Customer NPI it receives, transfers or obtains from a party only for the purpose for which the party delivered such NPI, and only for such other purposes permitted under 16 C.F.R. 313.14 and 313.15. Whereas, by use of this site and its forms, Customer acknowledges that any information submitted may be utilized by Concord Auto Sales and Service Incorporated for its intended purpose.

Manufacturers Notification:

The manufacturer(s) represented by Concord Auto Sales and Service Incorporated may require that we submit certain Customer NPI for each vehicle transaction. This required information might include financial information regarding whether the vehicle was leased or financed, the term of the transaction, the lending institution, information relating to extended warranties and other related documentation. The manufacturer typically requires this Customer NPI to confirm the sale of a vehicle for the purpose of initiating warranty coverage and the deliver of timely vehicle information to Customer about recalls and other notices. In order to deliver a vehicle to you at Concord Concord Auto Sales and Service Incorporated we are attempting to obtain your Opt-In consent to submit this information in accordance with the provisions set forth in this disclaimer. If you elect to Opt-Out, there may be limited opportunities to receive certain products and services that you qualify to receive as a result of your vehicle transaction.

Customer Privacy Notice:

In connection with your vehicle transaction, Concord Auto Sales and Service Incorporated may obtain information about you of a financial nature that will fall under the protection of the GLB Act with regard to NPI. In accordance of the GLB Act, Customer should be aware of the following disclosures:

Concord Auto Sales and Service Incorporated collects Customer NPI from the following sources:

1: NPI received from Customer on forms, applications and in connection with financial transactions
2: NPI received about Customers based on transactions with Concord Auto Sales and Service Incorporated and third parties
3: NPI received from Consumer Reporting Agency about Customer
4: NPI received from any non-affiliated parties as permitted by law

Concord Auto Sales and Service Incorporated may disclose any Customer NPI while you are a Customer, potential Customer or previous Customer, to an affiliated party or non-affiliated party in accordance with the provisions of the GLB Act including but not limited to the following parties:

1: NPI disclosed to financial service providers, banks, credit unions and leasing companies
2: NPI disclosed to other financials institutions with whom we have joint marketing agreements
3: NPI disclosed to non-financial companies such as automobile manufacturers
4: NPI disclosed to other parties such as service providers and software maintenance companies
5: NPI disclosed to third party marketing companies and market research companies

NPI disclosed to any non-affiliated parties as permitted by law

 

 

 

 

Concord Auto Sales and Service  135 Commonwealth Avenue, Concord, MA 10742