Helms Auto Sales | 1101 Skyway Dr. Monroe, NC 28110 | 704-283-7115

 

 


Helms Auto Sales, Inc.
1101 Skyway Dr.
Monroe, NC 28110
704-283-7115

Finance

First
Name
  Middle   Last
Name
  Jr.
Sr.
Date of birth   Social
Security #
  Mothers
Maiden Name

Phone in
Applicants Home
  Phone in
Applicants Name
 
Phone #
Your E-mail Address
Drivers License #
State Issued
Expiration Date

Street Address   Apt, or Lot#  
City State   Zip Code
  Mortgage or Rent $ Time at Address yrs  mos
Name and Address of Landlord or Mortgage Holder
  Landlord or Mortgage Holder Phone

  If Less than 3 Years at Current Address, Please includes Previous Address History Below

Street Address   Apt, or Lot#  
City State   Zip Code Time at Address yrs  mos

Employed by or Type of business   Position
Address   City   State   Zip      
  Gross (Pre-tax)
Monthly Income
  Supervisor
Time Employed yrs  mos   Work Phone  
Source Of Other Income (1)   Monthly Amount      

Total monthly gross income (this amount is automatically calculated)

If Less than 3 Years at Current Employment, Please includes Previous Employment History Below

Previous Employer   Time Employed yrs  mos   Phone
Address   City   State   Zip      

Have you ever
had a car repossessed?
Date
Have you ever
had a Forclosure?
Date
Have Civil Judgements ever
been laid against you?
Date
Have you ever
filed for Bankruptacy?
Date

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