Contact Information

* First Name: * Last Name:
* Email: Home Phone:
* Day Phone:
* Address:
* City: * State: * ZIP Code:

Applicant Information

  Format: xxx-xx-xxxx   Format: MM/DD/YYYY
* Soc. Sec. No.: * Date of Birth:
Residence Type: Monthly Payment:
Years At Residence:

Employment Information

* Employer:
Occupation:
* Monthly Income:
Time On Job:
* Business Phone:
* Address:
* City: * State:
* Zip:

Loan Information

Applicant Type:
Amount Required:
Down Payment: Trade-In:

Vehicle Information

Year: Miles:
Make: VIN:
Model:

Other Income

Source: Monthly Income:

Additional Information

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I certify that I have provided true and accurate information in this form. By submitting this form, I authorize the dealer to begin a credit investigation, to process my application, and to forward my application to lenders, financial institutions, or other third parties in order to process my application.


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Desert Auto Plaza
602 S. Wake Avenue
El Centro, CA 92243-9543
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Phone: (760) 460-4412