Customer Information
Poe Motors Finance Application
Email *
Full Name (First, Middle, Last) *
Please list and label all phone numbers where you can be reached. (home, cell, work, etc.) *
Can we text you?  
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Email
Do you have a checking account?  Name of bank?
Date of Birth *
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Social Security Number *
Driver's License Number and State *
Physical Address (street number and name, city, State, zip) *
How long have you been at current residence? *
Own or Rent?  *
How much is your monthly mortgage or rent? *
Landlord name and number? *
Mailing address if different from physical?
If less than 5 years at current residence, please list previous address and how long you lived there.
Employer name, address, and phone number *
Employer supervisor name and phone number *
Hire date *
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DD
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YYYY
How many hours a week do you work?
How much do you make an hour? Or, if salary, how much monthly?
How do you get paid?
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If less than 2 years on job, please list previous employer and how long you worked there.
If not employed, what is your fixed income source and amount?
Who do you live with?
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If you live with someone; please give their name and cell number, and relation to you.
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