3250 Clifty Drive
Madison, IN 47250
812-274-3500
Site Menu
Inventory
All Inventory
Inventory Specials
Financing
Apply Online
Loan Calculator
Testimonials
Services
Value Your Trade-In
Vehicle Finder
Service Center
Our Store
Store Info
About Us
Meet Our Staff
Privacy Policy
APPLY FOR CREDIT
Applicant Information
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Social Security:
Date of Birth:
Drivers License Number:
Drivers License State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Drivers License Exp:
Mobile Phone:
Home Phone:
Email:
Time at Residence:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Residence Type:
Rent
Own
Living with Family
Military Housing
Other
Rent/Mortgage:
Applicant Employment Information
Employer:
Monthly Income:
Occupation:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Work Phone:
Time on Job:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Do you have a co-buyer?
Add Co-Buyer
Remove Co-Buyer
Co-Buyer Information
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Social Security:
Date of Birth:
Drivers License Number:
Drivers License State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Drivers License Exp:
Mobile Phone:
Home Phone:
Email:
Time at Residence:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Residence Type:
Rent
Own
Living with Family
Military Housing
Other
Rent/Mortgage:
Co-Buyer Employment Information
Employer:
Monthly Income:
Occupation:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Work Phone:
Time on Job:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Vehicle Information
Vehicle To Finance:
Select Vehicle to Finance
2013 Nissan Rogue SV AWD Red AWD Cloth Automatic SUV 2.5L L4 DOHC 16V Gasoline 1905 4 Cylinders - 1905
2013 Hyundai Elantra Limited Blue FWD Leather Automatic Sedan 1.8L L4 DOHC 16V Gasoline 1827 4 Cylinders - 1827
2013 Ford Escape SE FWD Gray FWD Cloth Automatic SUV 1.6L L4 DOHC 16V Gasoline 1152 4 Cylinders - 1152
2013 Chrysler Town & Country Touring Blue FWD Cloth Automatic Van-Minivan 3.6L V6 DOHC 24V Gasoline 1824 6 Cylinders - 1824
2011 GMC Acadia SLT-1 FWD White FWD Leather Automatic SUV 3.6L V6 DOHC 24V Gasoline 1903 6 Cylinders - 1903
2009 GMC Acadia SLT-1 AWD Red AWD Leather Automatic SUV 3.6L V6 DOHC 24V Gasoline 1902 6 Cylinders - 1902
2008 Suzuki SX4 Crossover Convenience Black 2WD Cloth 5 Speed Manual Hatchback 2.0L L4 DOHC 16V Gasoline 1108 4 Cylinders - 1108
2008 Ford F-150 XL SuperCab 4WD Black 4WD Cloth Automatic Truck 4.6L V8 SOHC 16V Gasoline 1908 8 Cylinders - 1908
2007 Kia Sedona EX LWB White FWD Cloth Automatic Van-Minivan 3.8L V6 DOHC 24V Gasoline 1634 6 Cylinders - 1634
2006 Nissan Altima 2.5 Gray FWD Cloth Automatic Sedan 2.5L L4 DOHC 16V Gasoline 1289 4 Cylinders - 1289
2006 Honda Pilot EX w/Leather and Navigation White AWD Leather Automatic SUV 3.5L V6 SOHC 24V Gasoline 1825 6 Cylinders - 1825
2006 Chevrolet Silverado 3500 Work Truck Crew Cab 4WD DRW Red 4WD Leather Automatic Truck 6.6L V8 OHV 32V TURBO DIESEL Diesel 1279 8 Cylinders - 1279
2006 Chevrolet Silverado 1500 LS Ext. Cab 4WD White 4WD Cloth Automatic Truck 5.3L V8 OHV 16V Gasoline 1904 8 Cylinders - 1904
2005 Chevrolet Suburban 1500 4WD White 4WD Leather Automatic SUV 5.3L V8 OHV 16V FFV Gasoline 1907 8 Cylinders - 1907
2004 Mercury Mountaineer Convenience 4.6L AWD Beige AWD Leather Automatic SUV 4.6L V8 SOHC 12V Gasoline 1273 8 Cylinders - 1273
2003 Infiniti G35 Coupe Silver RWD Leather Automatic Coupe 3.5L V6 DOHC 24V Gasoline 1906 6 Cylinders - 1906
2000 Jeep Grand Cherokee Laredo 4WD Beige 4WD Leather Automatic SUV 4.7L V8 SOHC 16V Gasoline 2127 8 Cylinders - 2127
1999 Ford Windstar SE Red FWD Cloth Automatic Van-Minivan 3.8L V6 OHV 12V Gasoline 1292 6 Cylinders - 1292
1995 Jeep Grand Cherokee Limited 4WD Dark Green 4WD Leather Automatic SUV 5.2L V8 OHV 16V Gasoline 1491 8 Cylinders - 1491
1995 Ford F-150 Special Reg. Cab Short Bed 2WD Red 2WD Cloth Manual Truck 4.9L L6 OHV 12V Gasoline 1826 6 Cylinders - 1826
Stock Number:
Year:
Make:
Model:
Trim:
Vin:
Mileage:
Additional Comments
ACKNOWLEDGMENT AND CONSENT:
I certify that the above information is complete and accurate to the best of my knowledge. Creditors receiving this application will retain the application whether or not it is approved. Creditors may rely on this application in deciding whether to grant the requested credit. False statements may subject me to criminal penalties. I authorize the creditors to obtain credit reports about me on an ongoing basis during this credit transaction and to check my credit and employment history on an ongoing basis during the term of the credit transaction. If this application is approved, I authorize the creditor to give credit information about me to its affiliates.
ACKNOWLEDGMENT AND CONSENT:
I hereby consent to receive text messages or phone calls from or on behalf of the dealer or their employees to the mobile phone number I provided above. By opting in, I understand that message and data rates may apply. This acknowledgement constitutes my written consent to receive text messages to my cell phone and phone calls, including communications sent using an auto-dialer or pre-recorded message. You may withdraw your consent at any time by texting "STOP".
Submit Credit App