FASSI
FLEET MAINTENANCE OF S FL
1117 53rd Ct., West Palm Beach FL 33407
 
Call Us: 561-881-1380

Fleet Maintenance of S FL, Sales and Service Since 1989

Commercial Loan Application

Please fill in the form below to apply for a loan or call us and we will take it over the phone.

Fields marked with a * are required.

To add a co-applicant check this box:
 
Select a Vehicle
Select A Vehicle:
Applicant Information
First Name:*
MI:
Last Name:*
Suffix (Jr./Sr./etc.):
Email:*
Social Security #:*
- -
Birth Date (MM-DD-YYYY):*
- -
Drivers License #:
Drivers License State:
Street #:*
Street Name:*
Type:
Apt./Suite #:
City:*
State:*
Zip:*
Home Phone #:*
- -
Cell Phone #:
- -
Time at Address:*
years months
Housing Status:*
Mtg Payment or Rent:*
Employment Status:*
Employers Name:*
Work Phone #:*
- -
How Long Employed:*
years months
Occupation:
Income (gross):*
Prefered Contact Method
Contact Method:*
Additional Comments
Comments:
Image Verification
Verify Image:* verification image, type it in the box
Authorization

The individual(s), recognizing that his or her individual credit history may be a factor in the evaluation of the credit of the applicant(s), hereby consents to and authorizes the above named business credit provider and any assignees, lender or funding service that may be utilized, to obtain and use a consumer credit report on the undersigned, now and from time to time, as may be needed in the credit evaluation and review process and waives any right or claim they would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent.



I agree to the above statement.
    
 
 
Home | New Inventory | Pre-Owned Inventory | Quick Quote | Specials | Contact Us | Map / Directions | Our Staff | Credit Application