Cote Auto Inc.

Application

Financial Application

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Financial Application- Basic Information

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Name: *

Address: *

Phone: *

E-mail address: *

Driver License # *

Birth Date: *

Social Security Number: *

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Employment Information

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Employer: *

Phone: *

Position: *

Supervisor: *

Full or Part time: *

Length of Employment: *

Gross Monthly Income: *

Source of Other Income (if any): *

Gross Monthly Other Income (if any): *

Employer Address: *

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Residence Information:

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Vehicle Information

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Vehicle applied for: *

Warranty: Yes/No? *

Amount available for down-payment: *

Current auto loan? Yes/no: *

Judgments/liens against you? Yes/no: *

Active bank account? yes/no:

Repossessions in past 2 years? yes/no:

Bankruptcy in past 5 years? yes/no/discharged:

Trade in? Yes/no: *

Trade in information: (if yes) (year, make, model, miles) *

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Where to find us:

Cote Auto Repair Inc.
493 Access Hwy
Limestone, ME 04750

Phone: (207) 325-4757

Dealership Hours

Mon-Fri 7:00 AM-5:30 PM

Sat. 8:00 AM-1:00 PM

New! Non Ethanol Super Gas

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