Keith's Auto Sales

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APPLY FOR CREDIT TO GET THIS VEHICLE!

Full Name

Check this box to authorize us to share your nonpublic personal information with affiliated and/or nonaffiliated third parties. I understand that in checking this that you may be better able to serve me and that I may receive offers for other products and services that may be of value to me. Please read our privacy policy for more information regarding your rights and how we use the personal information you submit to us.

Social Security #

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Home Phone

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Please type your full name

(Your application will be sent securely and encrypted using our secure server)

FAIR CREDIT REPORTING ACT DISCLOSURE:

This application for credit may be submitted by the Dealer to various financial institutions. Before this application is submitted, upon request, the Dealer will disclose to you the name and address of the institution(s) who will receive copies of this application.

By clicking on the 'submit' button above I certify that the above entered information to be true and correct and I hereby authorize you to use this information to perform a credit rating check of my personal credit. I also certify that I am over the age of 18 and am a current U.S. citizen or permanent resident. In addition, I understand that submitting the above information does not represent an obligation by any party to provide credit nor does it obligate me to accept any credit offered.