Contact Info

First Name*

Last Name*

Email Address*

Phone #*

Street Address*

Address line 2

City*

State*

Zip Code*

Date of Residency*

This is the date you started living at your current residence

Previous Address (Please include full address, city, state, and zip)*

Rent or Own?*

Monthly Rent/Mortgage Payment*

Date of Birth*

Social Security #*

Employment info

Employer Name*

Employer Phone #*

Gross Monthly Income (before taxes)*

Additional Income

Date of Employment*

Occupation or Job Title*

Previous Company Name*

Years employed at Previous Company*

Tell us about the vehicle you want

Year*

Make*

Model*

Trim*

Down Payment Amount*

Desired monthly payment?*

Do you have a vehicle to trade-in?*

Yes

HOW WOULD YOU LIKE US TO CONTACT YOU?

Call

Text

I agree to give permission for the above applicant(s) Consumer Credit Report(s) to be obtained, at no cost to me, in order to help determine the types and extent of financing which are available*

In connection with your transaction, Scott C's Auto Outlet may acquire information about you as described in this notice, which we handle as stated in this notice.

We may collect personally identifiable information such as name, postal address, telephone number, e-mail address, social security number, date of birth, etc. This personal information is collected and used by Scott C's Auto Outlet Credit Application staff for the purpose of facilitating a relationship or business transaction.

Our website resides behind a firewall and uses SSL (Secure Sockets Layer, the industry-standard security protocol used to communicate with browsers) to transmit personal information. Data is strongly encrypted during transmission to ensure that personal and payment information is secure. Industry-standard data encryption techniques are used to protect personal information.

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