Please review your information below and sign to authorize a credit check. APPLICATION DISCLOSURES:You authorize [Dealer Name] (“Dealer” “we” “us”), as part of the credit underwriting process, to submit this application to the financial institutions disclosed to you by us, for review. In addition, in accordance with the Fair Credit Reporting Act, you authorize us and the disclosed financial institutions, to submit your application for review to other financial institutions that may want to extend you credit for the proposed transaction or purchase your Retail Installment Contract and Security Agreement (“Contract”). You agree that we and/or the assignee of your Contract may obtain a consumer credit report periodically from one or more consumer credit reporting agencies (credit bureaus) in connection with the Contract and any update, amendment, renewal, refinancing, modification, extension, or collection of the debt incurred by the Contract. Upon your request, you will be informed whether or not a consumer report was ordered. If a report was requested you may be informed of the name and address of the consumer credit reporting agency that furnished the report. You agree that we may contact any party mentioned in this application, and any references you provide us, to verify the information you provided, and that we may gather whatever credit, residence, employment, and pay history we consider necessary and appropriate in evaluating this application, by any means available to us, and that anyone receiving a copy of this signed application is authorized to provide us with such information.We may keep this application and information about you whether or not the application is approved. You certify that the information on this application is true and complete. You understand that false statements may subject you to criminal penalties. FEDERAL NOTICES: IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.STATE NOTICES: Attention Arizona, California, Idaho, Louisiana, New Hampshire, Nevada, New Mexico, Ohio, Texas, Vermont, Washington or Wisconsin Residents: This application is not acceptable for your use. Do not complete this application! FAIR CREDIT REPORTING ACT DISCLOSURE: This application may be submitted to the following financial institutions: 1) [Dealer Name] 2) FIRST UNION FINANCIAL, LLC. APPLICATION AGREEMENTS: I the undersigned applicant named above, certify that I have provided true and accurate information in this application form, the supplemental references form, and other identification, residence, and income documents that I have provided, and that I have read, understand, and agree to the Application Disclosure and Notices above. By signing below, I authorize the Dealer to begin a credit investigation, to process my application, and to forward my application to the financial institutions named above and other lenders, financial institutions, or other third parties in order to process my application. INCLUDE WITH THIS APPLICATION: Full color image of Driver’s License, Pay stub or other proof of income, Proof of residence: utility bill or order confirmation email."