Guarantee Credit Acceptance

Contact Information

* First Name: * Last Name:
* Email: * Home Phone:
* Day Phone: Fax:
Cell Phone: * Preferred Contact:
* Address:
* City: * State: * ZIP Code:
Survey Questions
*Social Security Number:
*Employer and Employer Phone:
*Military rank or occupation:
*Length of employment:
*Hire date:
*Annual Income, before taxes:
*You wages are based on:
*How often are you paid?
*Residency Status:
*Rent/Mortgage payment:
*Do you have direct deposit?
*Do you have a trade in?
*If needed, do you have a co-signer?
*For the purpose of securing credit from you, I certify that the above information is true and complete to the best of my knowledge.
*I give the above information for the purpose of obtaining credit and I authorize you and any affiliate to verify this information, including obtaining credit bureau report(s).
* These fields are required
WARNING: Falsification of your Identification is fraud and will be prosecuted to the fullest extent of the law. I understand this application is subject to final credit approval at the dealership. By submitting this completed form, I acknowledge that I have read and understand the disclosures.
Howard Bentley Buick Pontiac GMC
1230 Huntsville Highway
Fayetteville, TN 37334
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Phone: (931) 227-4789
Email: Contact Us
Fax: (931) 433-0800