Required fields in red.

CONTACT INFORMATION
Email  
First & Last Name    
Street
Street 2
City, State & Zip     
Phone  
VEHICLE INFORMATION
Vehicle Year
Vehicle Make
Vehicle Model
Vehicle Mileage  
Year Bought
 
Loan Information
Who is your vehicle financed with? Name of Financial Institution:

 
Loan Type  
What is your current monthly payment? $  
Number of months remaining on loan?  
Comments
 

TERMS AND CONDITIONS OF THIS APPLICATION

You certify that all the representations contained in this application are truthful and correct and you hereby authorize Don Herring Mitsubishi and its affiliates and/or the Financial Institutions with whom it deals, to gather whatever credit and employment history they consider necessary and appropriate, including your consumer credit report. You also authorize Don Herring Mitsubishi and its affiliates to provide credit information concerning this transaction, including, if applicable, a consumer credit report, to the Financial Institutions. You understand that Don Herring Mitsubishi and its affiliates and/or any Financial Institution with whom it shares your information will retain this information whether or not your application is approved. You agree that you will notify Don Herring Mitsubishi and its affiliates and any applicable financing institution of any changes of name, address or employment prior to consummating your purchase or lease of a motor vehicle from Don Herring Mitsubishi and its affiliates. You understand that you may be required to provide verification of the representations made in this application and as such you may be required to provide additional documentation which includes, but is not limited to, W-2's, income tax returns, utility bills, financial statements and pay check stubs. You agree to provide, upon request such additional documentation as may be necessary to process this credit application.

Alimony, child support, or separate maintenance need not be revealed if you do not wish to have them considered as a basis for repaying this obligation.

Applicant, if married, may apply for separate account.

 I have read this agreement and accept all the terms described herein.

By submitting this application, you agree to all of the above terms and conditions.

 
Don Herring Mitsubishi, Dallas - Irving - Plano

DALLAS - 3520 South Marvin D. Love Freeway, Dallas, Texas 75224 - Sales: 888-880-4276
IRVING - 2901 W. Airport Freeway, Irving, Texas 75062 - Sales: 888-807-3216
PLANO - 4225 W. Plano Parkway, Plano, Texas 75093 - Sales: 888-868-9915
RED OAK CLEARANCE CENTER - 211 South I-35E, Red Oak, Texas 75154 - Sales: 972-617-7044
 
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