Gillie Hyde Auto Group

Short Info here... If you would like to fill this out over the phone, please call 1-866-327-9273

Dealer:

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Is this a joint application:

Yes

Personal Information

Last Name:

First Name:

Middle Init:

DOB:

SSN:

Current Address

Street/Apt.:

City:

State:

Zip/Postal Code:

Phone:

E-Mail Address:

Residence Type:

Years:

Months:

Rent/Mortgage:

Share Data:

Current Employment

Name:

Address:

Occupation:

Phone:

Income:

Period:

Time On Job: Years

Months:

Privacy Notice

In connection with your transaction we may obtain nonpublic person information about you and that information is handled as stated in this notice. This does not apply to information obtained in a non-financial transaction. 

We collect personal nonpublic information about you from the following sources. 

Information we receive from you on applications or other forms in connection with a financial transaction. 

Information about your transaction with us, our affiliates or others; and, 

Information we receive from a consumer reporting agency.

We may disclose all of the information we collect, as described above, to companies that perform marketing services or other functions on our behalf or to other financial institutions with whom we have joint marketing agreements.

We may also disclose nonpublic personal information about you, as a consumer, customer or former customer, to non-affiliated third parties as permitted by law.

Further, we restrict access to your nonpublic personal information to only those employees who need to know that information to provide products or services to you. Employees cannot use your information for any other purpose. For your protection, we maintain physical, electronic and procedural safeguards that comply with federal regulations to further guard your nonpublic information.

I hereby authorize my insurance carrier to provide my non-public personal insurance information to the above named dealership solely for the purpose of fulfilling and completing this transaction. The dealership named above is authorized to provide a copy of this document to obtain such information.

I agree with the Privacy Notice:

I certify I have attained the age of majority, I hereby authorize Gillie Hyde Auto Group to investigate my credit and employment history, and the release of that information to help attain financing.

I agree

Yes

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