7340 E. Caley Avenue, Suite 215W, Centennial, CO 80111 | P: (303) 471-8325 | F: (303) 471-8496 | www.HFICO.com | Submit to app@hfico.com Kingstar Credit ApplicationHow are you filing?SingleJointName* First * Middle Initial Last * Suffix Date of Birth* MM DD YYYY US Citizen?YesNoSocial Security Number*Email Address Home Phone With Area CodeCurrent Address* Street Address City* City State* AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Code* ZIP Code Length of Residence Years Months Length of Residence*Monthly PaymentOwn / Rent / OtherOwnRentWith ParentsOtherLandlord / Mortgage CompanyPrevious Address Street Address If less than two years at current residenceCity City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Code ZIP Code Previous AddressIf less than two years at current residence Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Length of Residence at Previous Address Years Months Length of Residence at Previous AddressCell PhoneBusiness Phone*Business / Employer*Occupation*Employment StatusEmployedSelf-EmployedLength of Employment Years Months Length of EmploymentGross Monthly Income*Additional IncomeSource of Additional IncomePrevious EmploymentIf less than two years at current jobPrevious OccupationLength of Previous Employment Years Months Length of Previous EmploymentCo-Applicant InformationCo-Applicant's relationship to Applicant*SpouseParentFamily MemberResides with ApplicantOtherOther*Name* Mr.Mrs.MissMs.Sr.Jr. Prefix First Middle Last Date of Birth* MM DD YYYY US Citizen?*YesNoSocial Security Number*Email Address Primary Phone*Current Address Same as Applicant's Street Address City City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip ZIP Code Length of Residence Years Months Length of ResidenceOwn / Rent / OtherOwnRentWith ParentsOtherMonthly PaymentLandlord / Mortgage CompanyPrevious AddressIf less than two years at current residence Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Previous Address Street Address If less than two years at current residenceCity City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip ZIP Code Length of Residence at Previous Address Years Months Length of Residence at Previous AddressCell PhoneBusiness Phone*Business / Employer*Occupation*Employment StatusEmployedSelf-EmployedLength of Employment Years Months Length of Employment*Gross Monthly Income*Additional IncomeSource of Additional IncomePrevious EmploymentIf less than two years at current jobPrevious OccupationLength of Previous Employment Years Months Length of Previous EmploymentAdditional CommentsDealer and Collateral InformationProduct TypeNew / UsedNewUsedYearMakeModelDealer NameDealer's PhoneDealer's FaxSubmitted ByPurchase PriceDown PaymentTrade-InPayoff Balance on TradeCash DownSales TaxTitle and Registration FeesOther FeesLoan AmountTerms and ConditionsTerms and ConditionsPlease read through the Agreement below and let us know you understand and agree by checking the “I Agree” box below. I certify that the above information stated in this application is true and correct and a complete statement of my financial condition. I understand that this application will be kept whether or not it is approved. Highlands Financial, Inc. is authorized to share this application with other potential lenders. HFI and any potential or subsequent creditor are authorized to check my credit and my employment history to answer questions about your credit experience with me and to disclose credit information to each other.Loan Application Terms I have read the above loan application terms and agree and accept them. Click to view the complete Highlands Financial loan application terms.Loan Application Terms*I/We certify that the above information stated in this credit application is true and correct to the best of my/our knowledge. By submitting this credit application, I/We authorize Highlands Financial and any other potential lender to do a credit inquiry, verify employment and answer any questions in consideration for an extension of credit. Click to view the complete Highlands Financial loan application terms. I agree and accept these loan application terms. Today's Date* Date Format: MM slash DD slash YYYY
