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Denbigh Auto Sales Financial Privacy Disclaimer:
 
In connection with your transaction, we may obtain information about you as described in this notice, which we handle as stated in this notice.

1. We collect nonpublic personal information about you from the following sources:
 Information that we receive from you on applications or other forms Information about your transaction with us, our affiliates or others; and Information we receive from consumer reporting agency.

2. We may disclose all of the information we collect, as described above, to companies that perform marketing services on our behalf or to other financial institutions with whom we have joint marketing agreements. We may not make such disclosures about you as a consumer, customer, or former customer.

3. We may also disclose nonpublic personal information about you as a consumer, customer or former customer, to nonaffiliated third parties as permitted by law.

4. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

Statement of Consent

I certify that the information provided by me is correct. I also understand that you will be checking with credit reporting agencies. I authorize an investigation of my credit and employment history and the release of information about my credit experience.

All fields must be filled in for processing

First Name:

Last Name:

E-mail Address:

Social Security Number:

  XXX-XX-XXXX

Birth date

  MM/DD/YY

Address Line One:

Address Line Two:

City:

State:

  i.e. VA, MD, DC

Zip Code:

Home Phone:

  XXX-XXX-XXXX

Time at Residence:

  Year(s)  Months

Residence Type:

Rent/Mortgage:

Per Month

Down payment Amount:

How would you rate your credit?

Vehicle Trade-In?:

Employer:

Gross Monthly Income:

XXX,XXX

Occupation:

Work Phone:

Time in Position

  Years  Month(s)

Other Income Source:

XXX,XXX

Gross Amount:

XXX,XXX

State-Required Disclosures

CALIFORNIA RESIDENTS: A married applicant may apply for an individual account.

MAINE RESIDENTS: Consumer reports (credit reports) may be obtained in connection with this application.

If you request, the creditor will inform you:  (1) whether or not consumer reports were obtained, and (2) if reports were obtained, the names and addresses of the consumer reporting agencies (credit bureaus) that furnished the reports.  You have the right to choose the agent and insurer for the insurance required by this transaction, but the insurer must be approved by the creditor.

NEW YORK RESIDENTS: A consumer credit report may be requested in connection with this application or in connection with updates, renewals, extensions or enforcement of any credit granted as a result of this application. Upon your request, the creditor will inform you whether or not a consumer credit report was requested, and if so, the name and address of the agency that furnished such report.

OHIO RESIDENTS: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

RHODE ISLAND RESIDENTS: A consumer credit report may be requested in connection with this application.

VERMONT RESIDENTS: I authorize the creditor to obtain credit reports on an ongoing basis about me from credit reporting agencies in connection with this extension of credit transaction.  The creditor may obtain credit reports about me on an ongoing basis in connection with this extension of credit transaction for any one or more of the following reasons:
(1) reviewing the account;
(2) increasing the credit line on the account;
(3) taking collection action on the account; or,
(4) any other legitimate purposes associated with the account.

WASHINGTON RESIDENTS: Please advise us if the creditor should investigate your credit references and/or credit history under another name.
 
MARRIED WISCONSIN RESIDENTS: No provision of a marital property agreement, a unilateral settlement agreement under Wis. Stat. 766.59, or a court decree under Wis. Stat. ?766.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree, or has actual knowledge of the adverse provision.

14704 Warwick Boulevard, Newport News, VA 23608
(757) 877-8300 | Fax (757) 875-5431
E-mail: 
info@denbighautosales.com

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