Finance Application

2012 Chevrolet Silverado 1500 LS

4 door Truck

Engine: 4.80 Vortec 4.8L V8 SPI VVT Flex Fuel
Transmission: 4-Speed Automatic with Overdrive

Ext. Color: Blue Granite
Int. Color: Dark Titanium
Stock Number: 150122

VIN: 3GCPCREA0CG230939 | Model Code: CC10543

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Contact Information

Sales Person's Name
First Name
Last Name
Middle Initial

Email
Direct Contact Phone
Work Phone

Social Security Number
Date of Birth
Drivers License Number
State of Issue

Address Information

Street
Apartment
City
State
Zip Code

Do you rent or own your residence?
Landlord/Mortgage Holder
Rent/Mortgage Monthly Amount

Time at Current Residence
yrs mos

Previous Residence
Previous Street
Previous Apartment
City
State
Zip Code

Employment Information

Place of Employment
Occupation
Business Phone
State

Time At Current Employer
yrs mos

Gross Income - Before Taxes
Other Income - Source
Other income - Amount

Previous Employer
Previous Occupation
Previous Employer Phone

Time At Previous Employer
yrs mos

Banking Information

Name of Bank
Account Types
Name of Bank
Account Types

Comments

Co-Applicant section

Co-Applicant Information

First Name
Last Name
Middle Initial
Email

Direct Contact Phone
Work Phone
Social Security Number
Date of Birth

Apartment
Street
City
State
Zip Code

Co-Applicant Employment Information

Place of Employment
Occupation
Business Phone
Drivers License Number

Time At Current Employer
yrs mos

Gross Salary
Net Salary
Other Income

Previous Employer
Previous Occupation
Previous Employer Phone

Time At Previous Employer
yrs mos

Important Privacy Information

Privacy Statement

FACTS 
What does Jim Ellis Automotive Dealerships do with your personal information?
Why? 
Financial companies choose how they share your personal information.  Federal law gives consumers the right to limit some but not all sharing.  Federal law also requires us to tell you how we collect, share, and protect your personal information.  Please read this notice carefully to understand what we do.
What? 
The types of personal information we collect and share depend on the product or service you have with us.  This information can include:
* Social Security number and income
* Account Balances and payment history
* Credit history and credit scores
When you are no longer our customer, we continue to share your information as described in this notice.
How? 
All financial companies need to share customers' personal information to run their everyday business.  In the section below, we list the reasons financial companies share their customers' personal information; the reasons JIM ELLIS AUTOMOBILE DEALERSHIPS chooses to share; and whether you can limit this sharing.
Reasons we can share your personal information
Does JIM ELLIS AUTOMOBILE DEALERSHIPS share? Can you limit this sharing?
For our everyday business purposes - 
...such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus
Does Jim Ellis Share? Yes Can you limit this sharing? No
For our marketing purposes?
To offer our produce and services to you
Does Jim Ellis Share? Yes Can you limit this sharing? No
For our affiliates? everyday business purposes-
Information about your transactions and experiences
Does Jim Ellis Share? Yes  Can you limit this sharing? No
For our affiliates? everyday business purposes?
Information about your creditworthinesa
Does Jim Ellis Share? Yes  Can you limit this sharing? Yes
For our affiliates to market to you
Does Jim Ellis Share? Yes  Can you limit this sharing? Yes
For our non-affiliates to market to you 
Does Jim Ellis Share? No  Can you limit this sharing? No
To limit our sharing -- Call 770-792-4511 or
Visit us online:  www.jimellis.com/optout.htm
Please note:
If you are a new customer, we can begin sharing your information (30) days from the date we sent this notice.  We you are no longer our customer, we continue to share your information as described in this notice.
However, you can contact us at any time to limit our sharing.
Questions? Call 770-792-4511 or go to www.jimellis.com/optout.htm
Who is providing this notice?
JIM ELLIS AUTOMOBILE DEALERSHIPS
How does JIM ELLIS AUTOMOBILE DEALERSHIPS protect my personal information? 
To protect your personal information from unauthorized access and use, we use security measures that comply with federal law.  These measures include computer safeguards and secured files and buildings.
How does JIM ELLIS AUTOMOBILE DEALERSHIPS collect my personal information?
We collect your personal information, for example, when you
* Apply for a lease or apply for financing
* Pay us by check or give us your contact information
* Show us your driver’s license
State laws and individual companies may give you additional rights to limit sharing.
Why can't I limit all sharing?
Federal law gives you the right to limit only
* Sharing for affiliates’ everyday business purposes information about your creditworthiness
* Affiliates from using your information to market to you
* Sharing for non-affiliates to market to you
State laws and individual companies may give you additional rights to limit sharing
What happens when I limit sharing for an account I hold jointly with someone else?
Your choices will apply to everyone on your account unless you tell us otherwise.
Definitions
Affiliates Companies - related by common ownership or control.  They can be financial and nonfinancial companies.
Non-affiliates - Companies not related by common ownership or control.  They can be financial and non-financial companies.
JIM ELLIS AUTOMOBILE DEALERSHIPS does not share with non-affiliates so they can market to you.
Joint marketing - A formal agreement between non-affiliated financial companies that together market financial products or services to you.
JIM ELLIS AUTOMOBILES DEALERSHIPS does not jointly market.
Our Affiliates:
D/B/A Jim Ellis Audi of A5tlanta
D/B/A Jim Ellis Audi of Marietta
D/B/A Jim Ellis Buick GMC Mall of Georgia
D/B/A Jim Ellis Chevrolet Buick GMC
D/B/A Jim Ellis Collision Center
D/B/A Jim Ellis Hyundai
D/B/A Jim Ellis Leasing
D/B/A Jim Ellis Mazda of Atlanta
D/B/A Jim Ellis Mazda of Marietta
D/B/A Jim Ellis Mitsubishi
D/B/A Jim Ellis Porsche
D/B/A Jim Ellis Saab Wheego of Atlanta
D/B/A Jim Ellis Volkswagen of Atlanta
D/B/A Jim Ellis Volkswagen of Marietta

If you have a joint account, your choice(s) will apply to everyone on your account unless you mark below.

Apply my choices only to me
Do not share information about my creditworthiness with your affiliates on their everyday business purposes.
Do not allow your affiliates to use my personal information to market to me.
I Authorize

(enter your initials)

Submit

Jim Ellis Chevrolet Atlanta

Sales: (877) 913-9800

Co-Applicant section