245 Starlite Rd
Mount Airy, NC 27030
336-789-4800
Site Menu
Inventory
Apply Online
Vehicle Finder
Visit Us
Our Store
About Us
Contact Us
Meet Our Staff
Testimonials
Privacy Policy
APPLY FOR CREDIT
Applicant Information
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Social Security:
Date of Birth:
Drivers License Number:
Drivers License State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Drivers License Exp:
Mobile Phone:
Home Phone:
Email:
Time at Residence:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Residence Type:
Rent
Own
Living with Family
Military Housing
Other
Rent/Mortgage:
Applicant Employment Information
Employer:
Employer Type:
Full-Time
Part-Time
Temporary
Fixed Income
Self-Employed
Cash Income
Monthly Income:
Occupation:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Work Phone:
Time on Job:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Do you have a co-buyer?
Add Co-Buyer
Remove Co-Buyer
Co-Buyer Information
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Social Security:
Date of Birth:
Drivers License Number:
Drivers License State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Drivers License Exp:
Mobile Phone:
Home Phone:
Email:
Time at Residence:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Residence Type:
Rent
Own
Living with Family
Military Housing
Other
Rent/Mortgage:
Co-Buyer Employment Information
Employer:
Employer Type:
Full-Time
Part-Time
Temporary
Fixed Income
Self-Employed
Cash Income
Monthly Income:
Occupation:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Work Phone:
Time on Job:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Vehicle Information
Vehicle To Finance:
Select Vehicle to Finance
2017 Ford Transit 250 Van High Roof w/Sliding Pass. 148-in. WB EL White FWD Cloth Automatic Cargo Van 3.7L V6 DOHC 24V Gasoline 1123 6 Cylinders - 1123
2017 Ford Fusion SE Black FWD Cloth Automatic Sedan 1.5L L4 DOHC 16V Gasoline 1168 4 Cylinders - 1168
2016 GMC Acadia SLT-1 FWD Gold FWD Leather Automatic SUV 3.6L V6 DOHC 24V Gasoline 1112 6 Cylinders - 1112
2016 Ford F-150 XLT SuperCab 2WD Burgundy RWD Cloth Automatic Pickup Truck 2.7L V6 DOHC 24V Gasoline 1169 6 Cylinders - 1169
2015 Hyundai Elantra SE Black FWD Cloth Automatic Sedan 1.8L L4 DOHC 16V Gasoline 1177 4 Cylinders - 1177
2014 Nissan Frontier S Crew Cab 5AT 2WD Charcoal RWD Cloth Automatic Pickup Truck 4.0L V6 DOHC 24V Gasoline 1148 6 Cylinders - 1148
2014 Honda CR-V 4WD LX Auto Charcoal 4WD Cloth Automatic SUV 2.4L L4 DOHC 16V Gasoline 1146 4 Cylinders - 1146
2014 Chevrolet Cruze LTZ Auto Silver FWD Leather Automatic Sedan 1.4L L4 DOHC 16V TURBO Gasoline 1138 4 Cylinders - 1138
2011 Honda Accord EX-L Sedan AT White FWD Leather Automatic Sedan 2.4L L4 DOHC 16V Gasoline 1159 4 Cylinders - 1159
2009 Toyota Corolla 4dr Sdn LE Auto Burgundy FWD Cloth Automatic Sedan 1.8L L4 DOHC 16V Gasoline 1140 4 Cylinders - 1140
2009 Honda Odyssey EX Blue FWD Cloth Automatic Van-Minivan 3.5L V6 SOHC 24V Gasoline 1170 6 Cylinders - 1170
2003 Chevrolet S10 Pickup LS Crew Cab 4WD Pewter 4WD Cloth Automatic Pickup Truck 4.3L V6 OHV 12V Gasoline 1187 6 Cylinders - 1187
Stock Number:
Year:
Make:
Model:
Trim:
Vin:
Mileage:
Sales Price:
Additional Comments
ACKNOWLEDGMENT AND CONSENT:
I certify that the above information is complete and accurate to the best of my knowledge. Creditors receiving this application will retain the application whether or not it is approved. Creditors may rely on this application in deciding whether to grant the requested credit. False statements may subject me to criminal penalties. I authorize the creditors to obtain credit reports about me on an ongoing basis during this credit transaction and to check my credit and employment history on an ongoing basis during the term of the credit transaction. If this application is approved, I authorize the creditor to give credit information about me to its affiliates.
ACKNOWLEDGMENT AND CONSENT:
By checking this box I hereby consent to receive customer care text messages and/or phone calls from or on behalf of Jimmy's Used Cars or their employees to the mobile phone number I provided above. By opting in, I understand that message and data rates may apply. This acknowledgement constitutes my written consent to receive text messages to my cell phone and phone calls, including communications sent using an auto-dialer or pre-recorded message. You may withdraw your consent at any time by texting "STOP" or "HELP" for help. See our https://jimmysusedcars.com/privacy for more information.
Submit Credit App