25600 75th St
Salem, WI 53168
262-586-8028
hometownautoexchange@gmail.com
Site Menu
Inventory
Financing
Apply Online
Loan Calculator
Testimonials
Services
Value Your Trade-In
Vehicle Finder
Our Store
Store Info
About Us
Meet Our Staff
Privacy Policy
APPLY FOR CREDIT
Applicant Information
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Social Security:
Date of Birth:
Drivers License Number:
Drivers License State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Drivers License Exp:
Mobile Phone:
Home Phone:
Email:
Time at Residence:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Residence Type:
Rent
Own
Living with Family
Military Housing
Other
Rent/Mortgage:
Applicant Employment Information
Employer:
Monthly Income:
Occupation:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Work Phone:
Time on Job:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Do you have a co-buyer?
Add Co-Buyer
Remove Co-Buyer
Co-Buyer Information
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Social Security:
Date of Birth:
Drivers License Number:
Drivers License State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Drivers License Exp:
Mobile Phone:
Home Phone:
Email:
Time at Residence:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Residence Type:
Rent
Own
Living with Family
Military Housing
Other
Rent/Mortgage:
Co-Buyer Employment Information
Employer:
Monthly Income:
Occupation:
Address 1:
Address 2:
City:
State:
AB
AL
AK
AZ
AR
BC
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MB
MI
MN
MS
MO
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip:
Work Phone:
Time on Job:
Years:
0 Years
1 Years
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12+ Years
Months:
0 Months
1 Months
2 Months
3 Months
4 Months
5 Months
6 Months
7 Months
8 Months
9 Months
10 Months
11 Months
Vehicle Information
Vehicle To Finance:
Select Vehicle to Finance
2017 Mitsubishi Outlander GT S-AWC Black AWD Leather Automatic Wagon 3.0L SOHC V6 MIVEC 24 Valve Gasoline 1274 6 Cylinders - 1274
2016 Dodge Dart 4dr Sdn SXT *Ltd Avail* White FWD Cloth Automatic Sedan 2.4L I4 MultiAir Gasoline 1404 4 Cylinders - 1404
2015 GMC Sierra 2500HD Denali Crew Cab 4WD Black Select Leather Automatic Truck 6.6L V8 OHV 16V DIESEL Diesel 1031 8 Cylinders - 1031
2014 Toyota Camry Hybrid 2014.5 4dr Sdn SE Limited Edition (Natl) Gray FWD Cloth Automatic Sedan 2.5L I-4 DOHC Hybrid Hybrid 1288 4 Cylinders - 1288
2013 Ford Focus 4dr Sdn Titanium Burgundy FWD Leather Automatic Sedan 2.0L GDI I4 flex fuel engine Gasoline 1222 4 Cylinders - 1222
2012 MINI Cooper Countryman FWD 4dr S Green FWD Leather Automatic Wagon 1.6L OHC 16-valve I4 VVT twin-scroll turbocharged engine Gasoline 1248 4 Cylinders - 1248
2012 Jeep Wrangler 4WD 2dr Sport Maroon 4WD Cloth 6 Speed Wagon 3.6L SMPI 24V VVT V6 engine Gasoline 1290 6 Cylinders - 1290
2012 Jeep Wrangler 4WD 2dr Sport Burgundy 4WD Cloth 6 Speed Wagon 3.6L SMPI 24V VVT V6 engine Gasoline 1403 6 Cylinders - 1403
2012 Chevrolet Silverado 2500HD 4WD Crew Cab 153.7" LTZ Silver 4WD Leather Automatic Truck DURAMAX 6.6L TURBO DIESEL V8, B20-DIESEL COMPATIBLE Diesel 1402 8 Cylinders - 1402
2011 Jeep Compass 4WD 4dr Silver 4WD Cloth Automatic Wagon 2.4L DOHC 16V I4 dual-VVT engine Gasoline 1291 4 Cylinders - 1291
2011 Cadillac CTS Sedan 4dr Sdn Premium 3.6L AWD Black AWD Leather Automatic Sedan Engine, 3.0L V6 SIDI DOHC VVT (270 hp [201 kW) @ 7000 rpm, 223 lb-ft of torque [302 Nm] @ 5700 rpm) 1296 6 Cylinde - 1296
2010 Subaru Forester 4dr Auto 2.5X Limited Silver AWD Leather Automatic Sedan 2.5L SOHC SMPI 16-valve 4-cyl boxer engine 1244 4 Cylinders - 1244
2010 Ford Super Duty F-250 SRW 4WD SuperCab 142" Lariat White 4WD Cloth Automatic Truck 6.4L OHV TURBO-DIESEL POWER STROKE V8 ENGINE Diesel 1267 8 Cylinders - 1267
2009 Jeep Wrangler 4WD 2dr X Green 4WD Cloth 6 Speed Wagon 3.8L OHV 12-valve SMPI V6 engine Gasoline 1299 6 Cylinders - 1299
2009 Ford Escape FWD 4dr V6 Auto XLT Blue FWD Cloth Automatic Wagon 3.0L DOHC SEFI 24-valve V6 Duratec engine Gasoline 1285 6 Cylinders - 1285
2009 Bentley Continental Flying Spur Speed Silver AWD Leather Automatic Sedan 6.0L DOHC 48-valve EFI twin-turbocharged W12 engine w/variable valve timing Gasoline 1245 12 Cylinders - 1245
2008 GMC Envoy 4WD 4dr SLE1 Purple 4WD Cloth Automatic Wagon Engine, Vortec 4.2L I6 SFI with transmission oil cooler (285 hp [212 kW] @ 6000 rpm), 276 lb-ft of torque [374 Nm] @ 4600 rpm) Gasolin - 1293
2008 Ford Super Duty F-250 SRW 4WD SuperCab 142" Lariat Blue 4WD Cloth Automatic Truck 6.4L OHV V8 TURBO-DIESEL POWER STROKE ENGINE Diesel 1411 8 Cylinders - 1411
2008 Ford Super Duty F-250 SRW 4WD Reg Cab 137" XLT White 4WD Cloth Automatic Truck 5.4L SOHC 24-valve SMFI Triton V8 engine Gasoline 1294 8 Cylinders - 1294
2008 Ford F-250 SD XL SuperCab 4WD White 4WD Cloth Automatic Truck 6.4L V8 OHV 32V TURBO DIESEL Diesel 1161 8 Cylinders - 1161
2008 Ford F-150 4WD SuperCab 145" XLT Blue 4WD Cloth Automatic Truck 5.4L 24-VALVE EFI FFV V8 ENGINE Gasoline 1407 8 Cylinders - 1407
2008 Bentley Continental Flying Spur 4dr Sdn Blue AWD Leather Automatic Sedan 6.0L DOHC 48-valve EFI twin-turbocharged W12 engine w/variable valve timing Gasoline 1246 12 Cylinders - 1246
2007 Ford F-150 4WD SuperCrew 139" King Ranch Red 4WD Leather Automatic Truck 5.4L 24-VALVE EFI FFV V8 ENGINE Gasoline 1298 8 Cylinders - 1298
2007 Chevrolet Silverado 2500HD 4WD Reg Cab 133" Work Truck Silver 4WD Cloth Automatic Truck Engine, Vortec 6.0L Variable Valve Timing V8 SFI (353 hp [262.8 kW] @ 5400 rpm, 373 lb-ft of torque [5 - 1223
2007 Bentley Continental Flying Spur 4dr Sdn Copper AWD Select Automatic Sedan 6.0L DOHC 48-valve EFI twin-turbocharged W12 engine w/variable valve timing Gasoline 1264 12 Cylinders - 1264
2006 Jeep Wrangler 2dr Rubicon Silver 4WD Cloth 5 Speed Wagon 4.0L SMPI I6 "Power Tech" engine Gasoline 1277 6 Cylinders - 1277
2006 Chevrolet Silverado 2500HD Ext Cab 143.5" WB 4WD LT1 White 4WD Cloth Automatic Truck DURAMAX 6600 TURBO DIESEL V8 Diesel 1282 8 Cylinders - 1282
2006 Chevrolet Silverado 2500HD Ext Cab 143.5" WB 4WD LT1 Blue 4WD Cloth Automatic Truck Engine, Vortec 6000 V8 SFI (300 HP [223.8 kW] @ 4400 rpm, 360 lb.-ft [486.6 N-m] @ 4000 rpm) Gasoline 1297 - 1297
2006 Chevrolet Silverado 1500 Crew Cab 143.5" WB 4WD LT2 Blue 4WD Cloth Automatic Truck VORTEC HIGH-OUTPUT 6000 V8 SFI Gasoline 1400 8 Cylinders - 1400
2005 GMC Sierra 2500HD Crew Cab 153" WB 4WD SLE Gray 4WD Cloth Automatic Truck Engine, Vortec 6000 V8 SFI (300 HP [223.8 kW] @ 4400 rpm, 360 lb.-ft. [486.6 N-m] @ 4000 rpm) Gasoline 1275 8 Cylind - 1275
2005 Ford Super Duty F-250 Reg Cab 137" XLT 4WD Gray 4WD Cloth Automatic Truck 6.0L DI V8 TURBO-DIESEL "POWER STROKE" ENGINE Diesel 1408 8 Cylinders - 1408
2005 Chevrolet Silverado 3500 Regular Cab 2WD White RWD Cloth Automatic Truck 6.6L V8 OHV 32V TURBO DIESEL Diesel 1082 8 Cylinders - 1082
2004 Jeep Wrangler 2dr X Blue 4WD Cloth Automatic Wagon 4.0L SMFI I6 "Power Tech" engine 1405 6 Cylinders - 1405
2003 GMC Sierra 2500HD Reg Cab 133" WB 4WD Orange 4WD Leather Automatic Truck DURAMAX 6600 TURBO DIESEL V8 Diesel 1272 8 Cylinders - 1272
2003 GMC Sierra 2500HD Ext Cab 143.5" WB 4WD SLT Beige 4WD Leather Automatic Truck DURAMAX 6600 TURBO DIESEL V8 Diesel 1401 8 Cylinders - 1401
2003 Ford Super Duty F-450 DRW Super Cab 162" WB 60" CA Lariat 4WD Blue 4WD Cloth Automatic Truck 6.0L (366) DI V8 TURBO-DIESEL ENGINE Diesel 1251 8 Cylinders - 1251
2003 Chevrolet Silverado 2500HD Crew Cab 167" WB 4WD White 4WD Select Automatic Truck DURAMAX 6600 TURBO DIESEL V8 Diesel 1177 8 Cylinders - 1177
2003 Chevrolet Silverado 2500HD Crew Cab 153" WB 4WD LS Silver 4WD Cloth Automatic Truck DURAMAX 6600 TURBO DIESEL V8 Diesel 1280 8 Cylinders - 1280
1999 Jeep Wrangler 2dr Sport Red 4WD Select Automatic Wagon 4.0L (242) SMPI I6 "Power Tech" engine Gasoline 1217 6 Cylinders - 1217
1999 Jeep Wrangler 2dr SE Black 4WD Cloth Automatic Wagon 2.5L (150) SMPI 4-cyl engine Gasoline 1406 4 Cylinders - 1406
1972 Fiat 124 Spider Abarth Convertible White RWD Vinyl 5 Speed Classic Car 1400 Gasoline 1070 4 Cylinders - 1070
Stock Number:
Year:
Make:
Model:
Trim:
Vin:
Mileage:
Sales Price:
Additional Comments
ACKNOWLEDGMENT AND CONSENT:
I certify that the above information is complete and accurate to the best of my knowledge. Creditors receiving this application will retain the application whether or not it is approved. Creditors may rely on this application in deciding whether to grant the requested credit. False statements may subject me to criminal penalties. I authorize the creditors to obtain credit reports about me on an ongoing basis during this credit transaction and to check my credit and employment history on an ongoing basis during the term of the credit transaction. If this application is approved, I authorize the creditor to give credit information about me to its affiliates.
ACKNOWLEDGMENT AND CONSENT:
I hereby consent to receive text messages or phone calls from or on behalf of the dealer or their employees to the mobile phone number I provided above. By opting in, I understand that message and data rates may apply. This acknowledgement constitutes my written consent to receive text messages to my cell phone and phone calls, including communications sent using an auto-dialer or pre-recorded message. You may withdraw your consent at any time by texting "STOP".
Submit Credit App
Text Us
Text us
×
Close
First Name
Last Name
Mobile Phone
Comments
ACKNOWLEDGMENT AND CONSENT:
I hereby consent to receive text messages or phone calls from or on behalf of the dealer or their employees to the mobile phone number I provided above. By opting in, I understand that message and data rates may apply. This acknowledgement constitutes my written consent to receive text messages to my cell phone and phone calls, including communications sent using an auto-dialer or pre-recorded message. You may withdraw your consent at any time by texting "STOP".