Loan Information * Applicant Type: Individual Joint * Amount Required: * Loan Term: Choose A Term 12 Months 24 Months 36 Months 48 Months 60 Months 72 Months 84 Months * Down Payment: * Trade-In: Yes No Vehicle Information Year: Miles: Make: VIN: Model: Employment Information * Employer: * Occupation: * Monthly Income: * Time On Job: Years 0 Years 1 Year 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10+ Years Months 0 Months 1 Month 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months * Business Phone: * Address: * City: * State: Select One AK AL AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA ME MD MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY * Zip: Other Income Source: Monthly Income: Contact Information * First Name: * Last Name: * Email: Home Phone: * Day Phone: Fax: Cell Phone: * Preferred Contact: Email Home phone Day phone Cell phone Fax * Address: * City: * State: Select One AK AL AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA ME MD MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY * ZIP Code: Applicant Information   Format: xxx-xx-xxxx   Format: MM/DD/YYYY * Soc. Sec. No.: * Date of Birth: * Residence Type: Own Rent * Monthly Payment: * Years At Residence: Years 0 Years 1 Year 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10+ Years Months 0 Months 1 Month 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months Additional Information Message Text: * These fields are required I certify that I have provided true and accurate information in this form. By submitting this form, I authorize the dealer to begin a credit investigation, to process my application, and to forward my application to lenders, financial institutions, or other third parties in order to process my application. Whenever other companies or third parties provide support services on our behalf, we require them to conform to our confidentiality and information security standards. They are allowed to use confidential information only to provide the service or product on Halladay Motors's behalf. Before we can accept your application, you must read and agree to the following: I certify that the information provided by me is correct. I also understand that you will be checking with credit reporting agencies. I authorize an investigation of my credit and employment history, receipt of a GLB privacy act notice by mail, and the release of information about my credit experience to a third party lending institution.

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PRIVACY POLICY: Halladay Motors's Pledge Regarding the Responsible Use and Protection of Customer Information

At Halladay Motors we respect the confidentiality of your personal information, and it is our ongoing responsibility to ensure that it is protected. We are providing you with this notice to inform you of how Halladay Motors responsibly uses and safeguards your nonpublic personal information. By "nonpublic personal information" we mean personally identifiable information that has not been obtained from a public source. Some examples of this are your social security number or the name of your employer. We encourage you to read this notice and to call, visit or email us if you have any questions.

The following is our continuing commitment to the responsible use and protection of your confidential information:

a) Protection of Confidential Information: We will safeguard, according to prudent security standards, the confidentiality of all nonpublic personal information you provide for us.

b) Collection, Use and Retention of Confidential Information: Halladay Motors limits the collection, use and retention of confidential information to what we believe is necessary to administer our business, to provide you with exceptional quality service, to comply with regulatory retention of information, and to make available to you other promotions, services, and opportunities that may be of benefit or interest to you. For example, your information may be used to evaluate your eligibility for a loan or other services.

c) Information Collection: We may collect:

Information we receive from you on applications and forms, or other information that you provide for us – for example: your income or where you work;

Information you voluntarily submit for example, your fax number, your e-mail address;

Information about your transactions with our affiliates, others or us.

Information we receive from a consumer-reporting agency, such as your creditworthiness, your employment verification, etc.

d) Security Procedures to Protect Confidential Information: A fundamental element of safeguarding your confidential information is to provide protection against unauthorized access or use of this information. We restrict access to nonpublic information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your non-public information.

e) Sharing Information with Third Parties Outside of Halladay Motors: We may be required to or may share some or all of the information that we collect about you, as permitted by law, for the following purposes-
to third parties to process or service a financial transaction that you requested or authorized
to insurance companies who underwrite your vehicle
to state registration agencies, our regulators and auditors
to consumer reporting agencies
to vehicle manufacturer
to third parties that assist us in marketing our accounts and service
to third parties that provide support for services for our products, such as companies that service our mailings.
to respond to a subpoena, court order or judicial process.

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