Contact Info

First Name*

Last Name*

Middle Initial

Email Address*

Date of Birth*

Day Time Phone #*

Evening Phone

Street Address*

Address line 2

City*

State*

Zip Code*

Residence Type*

Date of Residency*

Monthly Rent/Mortgage*

Social Security #*

Employment info

Employer Name*

Employer Phone #*

Job Title*

Employment Status*

Date of Employment*

Gross Monthly Income*

Additional Income Source

Additional Monthly Income

Purchase Info

Purchase Type*

Year*

Make*

Model*

Trim*

Stock Number

Down Payment (not including trade)*

Trade Info

Trade-In?*

Trade-In Year

Trade-In Make

Trade-In Model

Trade-In Mileage

Trade-In Condition

Trade-In Payoff Amount

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, Crestmont Toyota 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 Crestmont ToyotaCredit 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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