Credit Application for:
Retail
Lease
Balloon
APPLICANT INFORMATION
Last Name First Name Middle Birthdate Social Security No.
Address (Residence) City State Zip How Long:
______ Yrs. ______ Mos.
Drivers License No.
Home Phone
Cell Phone Mailing Address (if different from Home
Address) City State Zip
Residential Status:
Own
Rent
Buying
Parents
Other _________________________________________
Monthly Rent/Mtg. Pmt. $ __________________
Previous Full Address (if less than 3 years)
How Long:
______ Yrs. ______ Mos.
E-Mail Address:
EMPLOYMENT and INCOME INFORMATION: Note - Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered as a basis for repaying this obligation.
Employer Name /
Self-Employed
Monthly Income: $
Length of Employment
______ Yrs. ______ Mos.
Occupation
Other Income: $
Source:
Current Work Phone Number
Previous Employer Name
(If less than 3 years) Length of Employment
______ Yrs. ______ Mos.
Occupation
CO-APPLICANT INFORMATION - This Person is a: Spousal Joint Applicant Joint Applicant Co-signer/Guarantor Non-Applicant Spouse
Last Name First Name Middle Birthdate Social Security No.
Address (If different than Applicant’s) City State Zip How Long:
______ Yrs. ______ Mos.
Drivers License No.
Home Phone
Cell Phone Mailing Address (if different from Home
Address) City State Zip
Residential Status:
Own
Rent
Buying
Parents
Other _________________________________________
Monthly Rent/Mtg. Pmt. $ __________________
Previous Full Address (if less than 3 years)
How Long:
______ Yrs. ______ Mos.
E-Mail Address:
EMPLOYMENT and INCOME INFORMATION: Note - Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered as a basis for repaying this obligation.
Employer Name /
Self-Employed
Monthly Income: $
Length of Employment
______ Yrs. ______ Mos.
Occupation
Other Income: $
Source:
Current Work Phone Number
Previous Employer Name
(If less than 3 years) Length of Employment
______ Yrs. ______ Mos.
Occupation
CREDIT and DEBT INFORMATION: If you are married and live in a community property state, or any property that will secure this credit is located in such, the Seller/Lessor
and AHFC* will assume that all assets and income are community property and all debts are community obligations, unless you indicate otherwise on this application.
Bank Reference: _______________________________________________ Account No.: _______________________________________________
Checking
Savings
Type of Loan:
Mortgage Payment: $ __________________ Balance: $___________________ Creditor: ______________________________________________
Auto Payment: $ __________________ Balance: $___________________ Creditor: ______________________________________________
Has any party to this application been the subject, or subject to bankruptcy proceedings?
Yes
No Explain, if yes. _____________________________________________
Has any party to this application ever obtained credit under a different name?
Yes
No If so, What name? ___________________________________________________
Had a vehicle repossessed?
Yes
No If so, explain: _______________________________________________________________________________________________
PLEASE PRINT — INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
INSTRUCTIONS:
You may apply for credit in your name alone, whether or not you are married.
(1)
Please indicate whether you are a
pplying
individually, or
With another person.
(2) Indicate your marital status here only if:
a)
you live in a community property state (AZ, CA, ID, LA, NM, NV, TX, WA, WI), or
b)
this is a joint application, or c) this is an application for secured credit.
MARRIED
UNMARRIED
SEPARATED
(3)
We intend to a
pply for joint credit
Applicant Initials
Co-Applicant Initials
(4)
If
you are applying for credit with another person, please complete all sections.
(5)
If you are married and live in a community property state,
or any property that will
secure this credit is located within a community property state, please provide
information about your spouse in the “Co-Applicant” section (even if this
application is in your name alone).
Will A
pplicant(s) be principal driver/operator? YES NO.
The vehicle being applied for will be used primarily for: (check one)
Personal, family or household use.
Business, commercial, or agricultural
purposes, or you are an organization or governmental entity.
SEE IMPORTANT INFORMATION ON THE FOLLOWING PAGE
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Applicant’s Initials:
___________ /
Co-Applicant’s Initials:
___________
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Reset Form
Print Form
STATE NOTICES
California Residents: If married you may apply for a separate account.
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.
Maine Residents: If your application is approved and credit is granted, you will be required to insure the vehicle against loss or damage. If this
application is for a lease, you will also be required to have liability insurance. You may place this insurance through the agent or broker of your
choice, whether or not such agent or broker is affiliated with the dealer or holder of your contract. Obtaining insurance from a particular agent or
broker will not affect the credit decision unless the insurance product selected violates the terms of your contract.
Married Wisconsin Residents: No agreement, unilateral statement or court decree relating to marital property adversely affects a creditor’s interest
unless prior to the time credit is granted the creditor is furnished a copy of the agreement, statement or decree, or has actual knowledge of the
adverse provision. If the credit for which you are applying is granted, your spouse will also receive notification that credit has been extended to you.
New York, Rhode Island and Vermont Residents: Consumer reports (credit reports) may be obtained in connection with this application. If you
request: 1) You will be informed whether or not consumer reports were obtained; and 2) If consumer reports were obtained, you will be informed of
the names and addresses of the consumer reporting agencies (credit bureaus) that furnished the reports. If this application for credit is approved,
you authorize AHFC* to request and use subsequent consumer reports in connection with (a) renewals or extensions of this credit; (b) reviewing your
credit; (c) for the purpose of taking collection action on this extension of credit; or (d) other legitimate reasons associated with this extension of credit.
GENERAL NOTICE FOR LEASE TRANSACTIONS
Notice is hereby given that Honda Lease Trust has assigned all of its rights (but not its obligations) to purchase and/or sell this vehicle to Honda
Finance Exchange, Inc. pursuant to the Sub-Servicing and Master Exchange Agreement. Notice for New York and Virginia Residents: The Trust
designation is HVT, Inc., as Trustee for Honda Lease Trust.
NOTICE OF MAILING OF PRIVACY NOTICES
PRIVACY NOTICE: AHFC Privacy Notice will be mailed to the applicant at the address provided in this credit application five to ten days after
funding. The Privacy Notice is also available at http://www.hondafinancialservices.com/account-management/printable-forms.
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References
Nearest relative not living with you:
Name Address Phone
Relationship
to Applicant
List 2 additional references:
Name Address Phone
Relationship
to Applicant
Please read and sign below: By your signature below, you certify that you have completed this application to obtain credit, and that all information provided by you for this application is true, correct and
complete. You understand and agree that this application and related credit information will be forwarded to AHFC* (or other financial institution if shown below), and AHFC* may be asked to buy the
retail installment contract or lease involved in this transaction. You authorize AHFC* to share the results of any credit report, credit investigation, or employment investigation (including the information
contained in this application) with the Dealer named below and any other person assisting you in obtaining an extension of credit. You also authorize the Dealer to receive copies of such reports and
investigations to: (1) assist you in a loan/extension of credit and (2) search for financing with third party lenders on your behalf. You authorize the Seller/ Lessor, AHFC* and any affiliate, agent, service
provider or assignee of AHFC* (collectively “We”, “Us” and “Our”) to make inquiries and obtain information about you as We deem appropriate, including obtaining credit reports, contacting your credit
references and/or your employer, investigating your credit and employment history, and contacting any person or department about your driving record. You also authorize Us to provide credit information
about this transaction to others for the purpose of initiating, monitoring, and servicing your account, and for other legally permissible purposes. You authorize Us to give a copy of this application to
anyone who has agreed to pay debts incurred on the basis of this application. If you provided your e-mail address on this application, you agree that any communications and correspondence to you
from any of the parties to this transaction may be effected by e-mail. You agree that if an account is created for you, all of the following will also apply: (a) AHFC* may monitor and record telephone calls
regarding your account to assure the quality of Our service or for other reasons; (b) you expressly consent to AHFC* using prerecorded/artificial voice messages, text messages and/or automatic dialing
equipment while servicing or collecting your account, as the law allows; (c) you agree that AHFC* may take these actions using the telephone number(s) that you provide Us in this credit application,
you provide to AHFC* in the future, or it obtains from another source, even if the number is for a mobile telephone and/or Our using the number results in charges to you.
*AHFC means and includes American Honda Finance Corporation and Honda Lease Trust, 20800 Madrona Avenue, Torrance, CA 90503
You are notified that your application may be submitted to (Name and Address required):
Applicant’s Signature
_________________________________ Da
te
______________ Co-Applicant’
s Signature
______________________________ Da
te:
______________
DEALER SECTION
Dealer Name Dealer #: Dealer Contact Person:
Honda Customer:
Yes
No
AHFC* Customer:
Yes
No
Year Make Model # MSRP
Loyalty:
Yes
No
Term: Income
Estimated Payments
$
Cap. Cost Red.
Adj. Cap. Cost
Sales Program:
New
Used
Certified
Miles:
___________________
Cash Price: Sales Tax:
Cash Down:
Trade-In Amount Amount Financed
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