Loan Application - For Use by Loan Officers HiddenApplication Type Vehicle DetailsVehicle Type*Please Select...AutoPre-approval AutoBoatPre-approval BoatAircraftMotorcycleRVIf you are still shopping please select "pre-approval"Year*Please Select...1900190119021903190419051906190719081909191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023Make* Model* Purchase Price*Please enter a number from 0 to 10000000.Loan Amount*Please enter a number from 0 to 10000000.Applicant DetailsName* First Last Email* Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Social Security Number* Home Phone*Cell PhoneContact PreferencePlease Select...Home PhoneWork PhoneCell PhoneResidence DetailsAddress* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioPuerto RicoOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Time at Residence (Years)*Please enter a number from 0 to 99.Please round to the nearest whole number.Time at Residence (Months)Please enter a number from 0 to 11.Please round to the nearest whole number.Residence TypePlease Select...Own HomeRentOtherMonthly PaymentsPlease enter a number from 0 to 10000000.Rental or mortgage payment.Employment DetailsIf retired, please provide most recent employment with current income.Employment Status*Please Select...EmployedSelf EmployedRetiredOtherEmployer* Position* Time at Employer (Years)*Please enter a number from 0 to 99.Please round to the nearest whole number.Time at Employer (Months)Please enter a number from 0 to 11.Please round to the nearest whole number.Yearly Income*Please enter a number from 0 to 10000000.Work PhoneOther IncomePlease enter a number from 0 to 10000000.Include: alimony, rentals, pension/SS, investments, etc.Other Income Source* Co-Applicant DetailsName* First Last Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Social Security Number* Home Phone*Cell PhoneContact PreferencePlease Select...Home PhoneWork PhoneCell PhoneCo-Applicant Residence DetailsSame Address as Applicant?* Yes No Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioPuerto RicoOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Time at Residence (Years)*Please enter a number from 0 to 99.Please round to the nearest whole number.Time at Residence (Months)Please enter a number from 0 to 11.Please round to the nearest whole number.Residence TypePlease Select...Own HomeRentOtherMonthly PaymentsPlease enter a number from 0 to 10000000.Rental or mortgage payment.Co-Applicant Employment DetailsIf retired, please provide most recent employment with current income.Employment Status*Please Select...EmployedSelf EmployedRetiredOtherEmployer* Position* Time at Employer (Years)*Please enter a number from 0 to 99.Please round to the nearest whole number.Time at Employer (Months)Please enter a number from 0 to 11.Please round to the nearest whole number.Yearly Income*Please enter a number from 0 to 10000000.Work PhoneOptional Vehicle ImagesIf a link or pictures are available, please add them here. This is not a requirement but may speed up the loan decisioning process.Link to Vehicle Images Upload Vehicle Images Drop files here or Select files Max. file size: 120 MB. DisclaimerAuto Application Disclaimer* I have read, understood, and agree to the following disclaimer: I/We have read this application and certify that everything I/We have stated is accurate. J.J. BEST BANC & CO. may provide such information set forth in the application and any other information it receives to another creditor for consideration. By submitting this application, I/We give J.J. BEST BANC & CO., its corporate affiliates, or its assigns, the authorization to access my/our credit reports, employment history, or any other information sources. I/We understand that the information I/We have provided is given to obtain credit from J.J. BEST BANC & CO. or its assignees, and that J.J. 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