APPLYING FOR FRESH START FINANCING Please fill out every field below
PERSONAL INFORMATION
First Name:		Home Phone Number:
Last Name		Mobile Phone Number:
Street Address		e-mail Address:
City:		Date of Birth:
State:		SS Number:
Zip Code:
RESIDENCE INFORMATION
Rent to Own:		Time at Residence:
Rent or Mortgage Amount:
PREVIOUS RESIDENCE INFORMATION
Previous Address:		Previous City:
Previous State:		Previous Zip:
EMPLOYMENT AND IMPORTANT INFORMATION
Current Employer:		Work Phone Number:
Starting Date:
Monthly Income:		Down Payment:
Please fill out the previous employer information below.
Previous Employer:		Work Phone Number:
		Time at Previous Job:
ARE YOU GOING TO NEED A CO-SIGNER FOR THIS APPLICATION?
Yes/No:
By typing in my name in the signature field below, I certify that the above information is true and correct to the best of my knowledge. By signing below, I give ProStar Motors authority to gather any necessary credit and reference informaiton on my behalf for the sole purpose of determining creditworthiness. All fields are required to process. Failure to provide all information requested can delay this application.
Signature:		Date:
THIS IS NOT A FINANCE CONTRACT. You certify that the above information is correct and accurate, and authorize the release of credit and employment history for the purpose of vehicle sale.