Credit Application

Online App

Online Credit Application

Please use this form to complete an online application that will be reviewed promptly.

After completing this form online, please click on the submit button located at the bottom of the form.

You may also use our Printable Form that may be faxed to us.

If you have any questions please contact us at

USA 1+ Phone: 847-985-1800

Fax: 847-985-1818

You may also use our Contact Us form.

Applicant Type
If Joint Applicant, Relationship to Applicant?

Last Name First Name
Address City State Zip
Phone Number with Area Code Email
Your Social Security Number Date of Birth
Number of dependants Age(s)

Please indicate current living status
How long have you lived at your current address? Yeas and Months
Name of Landlord or Mortgage Holder
Landlord - Mortgage Holder Address
City State Zip Phone
How much is your mortgage - rent payment per Month?

Previous address, if less than 2 years at current
City State Zip How Long There?

Your current employer
City State Zip How Long There?

Applicants Occupation - If Military, state rank
What is your work phone number? Include Area Code
What is your current GROSS Monthly Income before taxes?

Source of other income
* Alimony, child support or separate maintenance income need not be revealed if you do not wish
to have it considered as a basis for repaying this obligation.
What is the GROSS Monthly income from other sources before taxes?

Previous employer, if at current employer less than 2 years
City State Zip How Long There?

Please indicate the name of your bank
Bank Phone Number Contact Persons Name
Please indicate type of account(s) you have there
Account Numbers

Have you ever had a Car or Merchandise Repossessed?
If Yes... Indicate the Year and Month

Have you ever filed Bankruptcy?
If Yes... Indicate the Year and Month

Is Applicant Obligated to Make Alimony, Child Support or Separate
Maintenance Payments?
If Yes... Indicate the amount per month paid

Indicate whom Current or Previous cars financed or leased through

Creditors Name
City State Zip Date Opened
Account Number Monthly Payment
Unpaid Balance?

Creditors Name
City State Zip Date Opened
Account Number Monthly Payment
Unpaid Balance?

Please indicate the type of vehicle you would like to purchase
Make Model Year Stock Number

Comments or Questions regarding application

Thank you for the opportunity to serve you