Business Credit Application – Sign & Drive New York

Program Type Requested:

Retail

Lease

TRAC

Balloon

Business Legal Name (exact legal name):

DBA (if applicable):

Soc Sec # / Federal Tax ID#:

State of Organization:

Date Bus. Formed:

Description of Business or Service:

Gross Monthly Income:

Business Physical Address:

Street

City

State

Zip

Phone Number:

Fax Number:

Key Contact:

Principal Name:

Principal Address:

Title:

% Ownership:

Principal Name:

Principal Address:

Title:

% Ownership:

Principal Name:

Principal Address:

Title:

% Ownership:

Bank, Finance, Trade References

Bank Name:

Address:

Acct. No.

Contact:

Finance Reference Name:

Address:

Acct. No.

Contact:

Trade Reference Name:

Address:

Acct. No.

Contact:

Sole Proprietor or Guarantor

Individual (First Name, Middle Initial, Last Name,):

Social Security Number:

Date of Birth:

Home Address (Number and Street):

City:

State:

Zip Code:

Time at Present Address:

Years

Months

Monthly Rent / Mortgage Payment:

Home Phone

Cell Phone Number:

E-mail Address:

Employer Name and Address:

Phone Number:

Time on Job:

Years

Months

NOTE: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Monthly Income

Secondary Income:

Source

Nearest Relative not in household:

Relationship:

Address:

Phone Number:

Personal Reference:

Relationship:

Address:

Phone Number:

Signature

AGREEMENT By signing below, Borrower and Guarantor(s) (individually and collectively, “Applicants”) agree to and affirm the following: To induce GMF to extend credit or financial assistance, from time to time, Applicants and/or Dealer intend to have GMF rely upon the information provided in this statement in its credit making decisions. Nothing herein contained shall be construed as creating an obligation upon GMF to extend or continue to extend credit. The information provided is true, correct, complete, and prepared in accordance with generally accepted accounting principles. Applicants will notify GMF if there is any change in name, address, or any material adverse change 1) in any of the information contained in this commercial financing request; 2) in Applicants' financial condition; or 3) in Applicants' ability to perform their respective obligations to GMF. If no notice of change has been given, this shall be considered a continuing statement and substantially correct. Applicants hereby authorize GMF and its affiliates, successors, assigns and third-party service providers to investigate Applicants' accounts and credit history, and obtain, without limitation, credit reports, trade references, financial statements, tax returns and banking records, and contact any of Applicants' current or former employers or creditors, banks or other financial institutions with which either Applicant has or had financial dealings, and Applicants' franchisor(s), to verify any information contained herein or received in connection with this Business Credit Application which GMF deems relevant to the possible extension of credit to Applicants and release information about GMF’s credit experience with Applicants as permitted by law. Applicants authorize GMF to disclose information to any affiliate, assign, agent and third-party service provider, and hereby authorizes and directs any such creditor, bank, other institution and franchisor to disclose to GMF any information it may from time to time deem necessary, and hereby releases GMF and any such creditor, bank or other institution from any and all claims, demands, damages, expenses or liability whatsoever in connection with the disclosure of any information whatsoever. Applicants will keep all information obtained from GMF confidential, and will not disclose any information received from GMF. Without limiting the foregoing, Applicants specifically agree not to disclose any information obtained from GMF to any other lender or potential lender. Applicants certify to GMF that neither they nor any person or entity holding any interest in them nor any of their officers or managers are parties with whom GMF is prohibited from doing business pursuant to the regulations of the Office of Foreign Assets Control or any other law or regulation. If the foregoing certification is or becomes untrue, in whole or in part, at any time, Applicants jointly and severally agree to indemnify GMF for any claim, damage, loss, liability or expense GMF suffers by reason of the untruthfulness of the foregoing certification. Applicants agree that GMF, its affiliates, agents, assignees, service providers and finance lender may monitor and record telephone calls regarding Applicants' account to assure the quality of service or for other reasons permitted by applicable law. Applicants also expressly consent and agree to GMF using written, electronic or verbal means to contact Applicants as the law allows. This consent includes, but is not limited to, contact by manual calling methods, prerecorded or artificial voice messages, text messages, emails, and/or automatic telephone dialing systems. Applicants agree that GMF may do so using any email address or telephone number Applicants provide, now or in the future, including a number for a cellular phone or other wireless device, regardless of whether Applicants incur charges as a result. Applicants consent that GM and/or a GM dealer may contact Applicants with offers and product information. For information on the GM Privacy Statement, please visit www.gm.com/privacy or call 1-866-MY-PRIVACY (1-866-697-7482). If GMF elects to do so, Applicants authorize GMF to file a UCC-1 Financing Statement, showing GMF as secured party and Applicants as debtor. In the event GMF does not provide credit or financial assistance to Applicants, GMF will terminate any such UCC-1 Financing Statement. Residents in the states of California, Maine, Tennessee, New Hampshire, New York, Ohio, Rhode Island and Vermont agree that by signing below, they have been given the included state notices and agree to the additional terms.

Company:

Title

Date

Dealer Information

Dealership Name:

Dealer Number:

Dealer Contact:

Phone Number:

Fax Number:

Dealer Use Only

Vehicle Information:

VIN

Conditiion

New

Used

Demo

Certified Used

Year

Make:

Model:

Trim:

Options/Upfits:

Product Type:

Term:

MSRP:

Invoice/Wholesale Value

Wholesale Source:

Vehicle Bookout Date:

Cash Selling Price:

Sales Tax:

T&L:

Cash Down:

Front-End Fees:

Rebate:

Net Trade:

Acq Fee:

Unpaid Balance:

Service Plan:

Maintenance Plan:

Commercial GAP:

Back-End Fees:

Est. Amt. Financed

Estimated Payment:

Vehicle Options / Upfit Description:

Trade-In Information

Year:

Make:

Model:

Trim:

Trade-In Wholesale:

Lienholder:

Monthly Payment:

TCPA DISCLOSURE FOR COLLECTION/SERVICING

NOTICE AND AGREEMENT REGARDING E-MAILS AND CALLS/TEXT MESSAGES TO WIRELESS TELEPHONES: You agree, in order for us to service our account or to collect any amounts you may owe, we may contact you by telephone at any telephone number associated with your account, including land-line, wireless, cellular, or VoiP/internet telephone numbers, which could result in charges to you. We may also contact you at any e-mail address you provide to us or by sending text messages, which could result in charges to you. Methods of contact may include using pre-recorded/artificial voice messages and/or use of an automatic dialing device, as applicable. Your agreement and consent also extends to any other agents, affiliates, or entities to whom we may assign, transfer, or sell your obligation for servicing or collection. You may revoke your consent for any telephone number or email address you have provided by contacting us and letting us know.

TCPA DISCLOSURE FOR TELEMARKETING

I understand that GM Financial engages in telemarketing activity directly and through others that place calls on its behalf. I hereby expressly consent to receive calls on behalf of GM Financial, at all of the numbers provided above for purposes of encouraging the purchase or rental of, or investment in, property, goods or services in which I might be interested whether or not related to this contract. I recognize and acknowledge that I am not required, directly or indirectly, to accept this provision as a condition of purchasing any good or service. I recognize that by signing below, I will receive future autodialed calls and prerecorded telemarketing messages by and/or on behalf of GM Financial.

Company

Title:

Date:

STATE NOTICES

California Residents: Applicant, if married, may apply for a separate account. Maine and Tennessee Residents: You must have physical damage insurance covering loss or damage to the vehicle for the term of any contract. For a lease, you must also have the liability insurance as described in the lease. You may buy this insurance from anyone you choose. You do not have to buy it from someone affiliated with the dealer or an assignee of this contract. Your choice of insurance will not affect the credit approval process unless the insurance does not satisfy the contract requirements or the insurance company does not satisfy the reasonable standards of the dealer or an assignee of the contract. New Hampshire Residents: If applying for a balloon payment contract, you are entitled to receive upon request a written estimate of the monthly payment amount for refinancing the balloon payment in accord with the creditor’s existing refinance programs. You would be entitled to receive the estimate before you enter into a balloon payment contract. A balloon contract is an installment sales contract with a final scheduled payment that is at least twice the amount of one of the earlier scheduled equal periodic installment payments. New York Residents: In connection with this application, we may request a consumer report on you. If you request, we will inform you whether or not a consumer report was requested and, if it was, of the name and address of the consumer reporting agency that furnished the report. Additional consumer reports may be ordered without further notice to you in connection with any update, renewal or extension of credit granted. Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law. Rhode Island Residents: Credit reports may be obtained in connection with this application for credit. Vermont Residents: You authorize Dealer and any financial service provider with whom this application is shared, and each of their respective employees or agents, to obtain and verify information about you (including one or more credit reports, information about your employment and banking and credit relationships) that they may deem necessary or appropriate in evaluation your credit application. If your application is approved and credit is granted, you authorize the parties granting credit and/or holding your account, and their respective employees and agents, to obtain additional credit reports and other information about you in connection with reviewing the account, increasing the available credit on the account (if applicable), taking collection on the account, or for any other legitimate purpose.

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