Stone Mountain Nissan Commercial Business Credit Application

Legal Business Name(Required)

Type of Business(Required)

Corporate Structure(Required)

Tax ID Number(Required)

Year-End PBT(Required)

Date Established(Required)

Financial Statement Type

Phone

Website URL

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Do you store your business vehicles at the address listed above?(Required)

Yes

No

Vehicle Storage Address

Street Address Address Line 2 City State ZIP Code

Primary Driver Name

First Last

Driver's Phone

Driver's Email

Trade Name/DBA/Parent Company

State of Organization(Required)

Principal Name (1)

First Last

Address

Street Address Address Line 2 City State ZIP Code

Title

Ownership Percentage

Principal Name (2)

First Last

Address

Street Address Address Line 2 City State ZIP Code

Title

Ownership Percentage

Banking Information & Credit Sources

Financial Institution(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Account Number(Required)

Unpaid Balance(Required)

Contact Name(Required)

First Last

Contact Phone

Second Financial Account

Financial Institution

Address

Street Address Address Line 2 City State ZIP Code

Account Number

Unpaid Balance

Contact Name

First Last

Contact Phone

Third Financial Account

Financial Institution

Address

Street Address Address Line 2 City State ZIP Code

Account Number

Unpaid Balance

Contact Name

First Last

Contact Phone

Individual Name(Required)

First Last

Social Security Number(Required)

Birthdate(Required)

Present Address(Required)

Street Address Address Line 2 City State ZIP Code

Are you currently renting or buying?

How many years have you lived there?

Phone

Alternate Phone

Driver's License Number(Required)

License Issued State(Required)

Employer Information

Employer Name

Employer Phone Number

Employer Address

Street Address Address Line 2 City State ZIP Code

How many years have you worked there?

Previous Employer Name

Previous Employer Phone Number

Previous Employer Address

Street Address Address Line 2 City State ZIP Code

Financial Information

Monthly Income(Required)

Secondary Income

Source of Income

Gross Monthly Income from Business(Required)

Mortgage Holder/Landlord (Name & Address)(Required)

Contact Name(Required)

Monthly Payment(Required)

Phone

Bank Name & Address(Required)

Checking Account Number(Required)

Savings Account Number(Required)

Notice

I, THE UNDERSIGNED, HEREBY AUTHORIZE THE DEALER, NISSAN MOTOR ACCEPTANCE CORPORATION, INFINITI FINANCIAL SERVICES, NISSAN-INFINITI LT AND/OR (COLLECTIVELY “PROSPECTIVE CREDITORS”), TO VERIFY CREDIT AND EMPLOYMENT HISTORY AS STATED ABOVE AND TO ANSWER QUESTIONS ABOUT CREDIT EXPERIENCE WITH ME. IF THIS APPLICATION IS MADE PURSUANT TO ANY CREDIT PROGRAM FOR ATTENDEES AND/OR GRADUATES OF SCHOOLS OR EDUCATIONAL INSTITUTIONS, THEN PROSPECTIVE CREDITORS MAY VERIFY MY ELIGIBILITY FOR SUCH PROGRAM, INCLUDING BY INQUIRY TO MY SCHOOL(S) OR EDUCATIONAL INSTITUTION(S). INSURANCE RELATED TO THE CREDIT FOR WHICH I AM APPLYING MAY BE PURCHASED FROM AN INSURER OR AGENT OF MY CHOICE WHO MEETS PROSPECTIVE CREDITOR STANDARDS. IN CONNECTION WITH THIS APPLICATION FOR CREDIT, PROSPECTIVE CREDITORS MAY REQUEST A CREDIT REPORT. ON MY REQUEST, PROSPECTIVE CREDITORS WILL ADVISE ME IF THE REPORT WAS ACTUALLY ORDERED AND IF SO, THE NAME AND ADDRESS OF THE AGENCY THAT FURNISHED THE REPORT. PROSPECTIVE CREDITORS MAY ORDER SUBSEQUENT CREDIT REPORTS.

I AUTHORIZE PROSPECTIVE CREDITORS TO ASK MY PAST AND CURRENT CREDITORS (“CREDIT REFERENCES”), INCLUDING CREDITORS LISTED ABOVE OR ON MY CREDIT REPORT, ABOUT MY CREDIT PERFORMANCE WITH THEM AND TO DISCLOSE TO OTHER PERSONS, INCLUDING CREDIT REPORTING AGENCIES, INFORMATION ABOUT MY ACCOUNTS AND CREDIT EXPERIENCE. THIS SHALL BE A CONTINUING AUTHORIZATION FOR ALL PRESENT AND FUTURE REQUESTS AND DISCLOSURES. PROVISION BY PROSPECTIVE CREDITORS OF A COPY OF THIS AUTHORIZATION SHALL SERVE AS MY DIRECTION THAT MY CREDIT REFERENCES PROVIDE MY CREDIT PERFORMANCE INFORMATION.

EVERYTHING THAT I HAVE STATED IN THIS APPLICATION IS COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND CONSTITUTES MY ENTIRE APPLICATION FOR CREDIT WITH THE PROSPECTIVE CREDITORS. I UNDERSTAND THAT PROSPECTIVE CREDITORS WILL RETAIN THIS APPLICATION WHETHER OR NOT IT IS APPROVED. I WILL NOTIFY PROSPECTIVE CREDITORS, IF APPLICABLE, WITHIN A REASONABLE TIME OF ANY CHANGE IN MY NAME, ADDRESS OR EMPLOYMENT.

I agree to the terms.

Company

Date

Guarantor Name

First Last

Signature