Pre-Qualification

sham.gif (1107 bytes)Indicates required information.
You must be 18 years old or older.
_1.gif (1936 bytes) About Your Loan:
Down Payment:       
Applicant Type:       
Trade-In:
_2.gif (1686 bytes) Contact Information

sham.gif (1107 bytes)Name:

 sham.gif (1107 bytes)Email:

sham.gif (1107 bytes)Address:

 sham.gif (1107 bytes)Home Phone:

           Contact:

 Work Phone:

sham.gif (1107 bytes)City:

 Fax:

sham.gif (1107 bytes)State:

 Zip:
_3.gif (1679 bytes) About Your Employment:
sham.gif (1107 bytes)Employer:
sham.gif (1107 bytes)Occupation:
sham.gif (1107 bytes)Monthly Income:
sham.gif (1107 bytes)Time on Job:
sham.gif (1107 bytes)Business Phone:
sham.gif (1107 bytes)City:
sham.gif (1107 bytes)State:
sham.gif (1107 bytes)Zip:
_4.gif (1624 bytes) Your Personal Information:
sham.gif (1107 bytes)Soc. Security Number:
sham.gif (1107 bytes)Date of Birth:
sham.gif (1107 bytes)Residence Type:
sham.gif (1107 bytes)Monthy Payment:
sham.gif (1107 bytes)Years/Months at Residence:
_5.gif (1668 bytes) Your Trade-in:
Year:
Manufacturer:
Model:
Miles:
Condition:
Payoff :
Lien Holder:
I certify that the above information is complete and correct.
I authorize you to obtain credit reports about me and investigate my credit history.

Contact Us | Hours & Directions

Mike Fitzpatrick Ford-Lincoln-Mercury
238 Bullsboro Drive
Newnan, Georgia  30263

Phone: 770-502-3673
Fax: 770-253-2275
Email: cars@mikefitzpatrick-flm.com