Applicant's Personal Credit Information                                                                      *Required Fields

First Name*                                         MI                              Last Name*                                            Suffix (Jr./Sr./etc.)

                            None Jr. Sr. I II III IV

Social Security #*                               Date of Birth:(MM/DD/YYYY)*

--                                 //

Street Address*                                                       Apt./Suite

City*                                                       State*                  Zip Code*                         Home Phone #*

                                                 --

Time at Address*                                Housing Status*                                           Mtg. Pymt. or Rent

yrs. mos.                              Select Homeowner Rent Family Other                                        

Employment Status*                         Employed By*                                               Business Phone #

Select Employed Unemployed Retired Military Other Self-employed                                --

Time Employed*                                  Occupation                                                    Salary (Gross)*     Type

yrs. mos.                                              Select Weekly Bi-Weekly Monthly Annually

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have

considered as a basis for repaying this obligation.

Other Income (Monthly)                   Source of Other Income

Co-Applicant's Personal Credit Information

Relationship to Applicant

Other Spouse Relative

First Name                                         MI                    Last Name                                             Suffix (Jr./Sr./etc.)

                          None Jr. Sr. I II III IV

Social Security                              Date of Birth:(MM/DD/YYYY)

--                      //

Street Address                                                      Apt./Suite

City                                                     State                    Zip Code                       Home Phone #

                                             --

Time at Address                             Housing Status                                             Mtg. Pymt. or Rent

yrs. mos.                           Select Homeowner Rent Family Other                                         

Employment Status                      Employed By                                               Business Phone #

Select Employed Unemployed Retired Military Other Self-employed                              --

Time Employed                               Occupation                                                    Salary (Gross)     Type

yrs. mos.                                        Select Weekly Bi-Weekly Monthly Annually

Additional Comments:

By clicking the "Submit" button below, you (including each joint applicant) certify that you have review the James Mears Mazda Volvos Privacy Policy and that all of the statements in this application are true and complete and are made for the purpose of obtaining credit.  You request the Pollard Used Cars or their lending partners forward this application to other lenders for their consideration.  You authorize any lender who receives this application to retain it, to rely on it and to obtain such other information as it may require, including credit reports, to complete the processing of your request for credit.  You further authorize any lender who receives this application to inform Pollard Used Cars and its lending partners of its credit decision.