McCafferty Suzuki of Langhorne

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Contact Information

*First Name
*Last Name
Middle Initial

*Email
*Phone Number
Work Phone

*Social Security Number
*Date of Birth

Address Information

*Street
Apartment
*City
*State
*Zip Code

*Do you rent or own your residence?
Landlord/Mortgage Holder
*Rent/Mortgage Monthly Amount

*Time at Current Residence yrs mos

Previous Residence (Required if less than 2yrs at Current Residence)
Previous Street
Previous Apartment
City
State
Zip Code

Employment Information

*Place of Employment
*Occupation
*Business Phone
State

*Time At Current Employer yrs mos

*Gross Salary
Net Salary
Other Income

Previous Employer (Required if less than 2yrs at Current Employer)
Previous Occupation
Previous Employer Phone

Time At Previous Employer yrs mos

Banking Information

Name of Bank
Account Types
Name of Bank
Account Types

Current Auto Lender
Monthly Payment
Total Debt

Length of Loan yrs mos

Comments/Salesperson

Co-Applicant section

Co-Applicant Information

First Name
Last Name
Middle Initial
Email

Phone Number
Work Phone
Social Security Number
Date of Birth

Apartment
Street
City
State
Zip Code

Co-Applicant Employment Information

Place of Employment
Occupation
Business Phone

Time At Current Employer yrs mos

Gross Salary
Net Salary
Other Income

Previous Employer (Required if less than 2yrs at Current Employer)
Previous Occupation
Previous Employer Phone

Time At Previous Employer yrs mos

Privacy Notice

Privacy Statement

Privacy Notice:

In connection with your transaction, Fred Beans Family of Dealerships 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 we receive from you on applications or other forms;
     - Information about your transactions with us, our affiliates or others; 
     - and information we receive from a 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 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 non-affiliated 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.

I have read the above Privacy Statement and I will allow this dealership to reserve the right to disclose nonpublic personal information about me to third parties, such as market research firms, direct marketing companies, finance service providers and others who may from time to time seek to provide me information on valuable products or services. I have read the above Privacy Statement and I direct this dealership to not share nonpublic personal information about me to non-affiliated third parties, except as provided in this Privacy Policy.

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Sales: 866.818.7388

Finance Application