application

	Please fill out the personal finance information requested below and click the submit button. This form is for financing pre-approval and does not obligate you to purchase a vehicle.
Type of application:	individual joint
Last Name or Business Name (if business):
First Name:	*M.I.:*
Address:
City:
State:	*Zip:*
Phone:
Email:
Fax:
Soc. Sec.#:
Date of birth:	*MM/DD/YY:*
Home Ownership:	own rentfamilyother
Payment or Rent:
Time at address:	*Yrs. Mos.*

	Current Employer:
Employed by or business type (if business):
Phone:
Start Date:
Occupation:
Gross annual income:	*Other:*
Time employed:	*Yrs. Mos. Military rank*
Name of nearest relative not living with you:
Address:
Phone:
Co-applicant's Social Security#:

	I certify that the information provided by me is correct and I authorize you to check with credit reporting agencies:

Oconomowoc	Lake Mills
N48 W36216 Wisconsin Ave.	321 E. Tyranea Park Blvd.
Oconomowoc, WI 53066	Lake Mills, WI 53551
Phone: 262-567-5591	Phone: 920-648-2388
Metro Milw.: 262-367-5050	Metro Milw.: 262-252-3346
Fax: 262-567-8710	Fax: 920-648-4160
Email: gmjeep@lakelandgm.com	Email: lakelandbuypower@charterinternet.net

Lakeland GM & Jeep