Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Employer Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have you ever declared bankruptcy in the past?

No

Yes

Once your credit is approved, your sales consultant will go over your exact car, payment structure and get a final confirmation from you to get your car ready for delivery. If you change your mind after giving your final confirmation and decide *NOT* to lease/purchase a car from our company, you will be charged $595.00, payable to RDZIGN Inc. This fee is *not* charged if you lease/buy a car from our company. *

I AGREE

I, the main applicant, and/or co-applicant agree that the information inputted above on this credit application is entered truthfully. I, the main applicant, and/or co-applicant authorize RDZIGN, to submit my credit application to the dealer/finance company to continue the lease/purchase process. You may receive a call from the Finance Department for further verification. Your typed electronic signature (below) serves as your agreement to this term. *

I AGREE

Electronic Signature Date *

MM

DD

YYYY