2006 N Nelson Dr
Derby, KS 67037
316-788-8883
Site Menu
Inventory
All Inventory
Inventory Specials
Financing
Apply Online
Loan Calculator
Visit Us
Services
Value Your Trade-In
Vehicle Finder
Our Store
About Us
Contact Us
Meet Our Staff
Testimonials
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
PR
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
PR
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:
Employer Type:
Full-Time
Part-Time
Temporary
Fixed Income
Self-Employed
Cash Income
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
PR
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
PR
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
PR
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:
Employer Type:
Full-Time
Part-Time
Temporary
Fixed Income
Self-Employed
Cash Income
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
PR
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
2016 Dodge Grand Caravan SXT White FWD Cloth Select Van-Minivan 3.6L V6 DOHC 24V GR210499 0 Cylinders - GR210499
2012 Ford Fusion SE Burgundy Select Select Select Sedan 2.5L L4 DOHC 16V cr269642 0 Cylinders - cr269642
2011 GMC Savana G2500 Cargo White RWD Cloth Automatic Van-Minivan 6.0L V8 OHV 16V FFV B1125445 8 Cylinders - B1125445
2010 Honda Odyssey EX Blue FWD Cloth Automatic Van-Minivan 3.5L V6 SOHC 24V AB085536 6 Cylinders - AB085536
2009 Ford F-250 SD XLT SuperCab 4WD White 4WD Cloth Automatic Truck 6.8L V10 SOHC 30V Gasoline 9EA18137 10 Cylinders - 9EA18137
2009 Chevrolet Impala LT Silver FWD Cloth Automatic Sedan 3.5L V6 OHV 12V FFV Gasoline 91174107 6 Cylinders - 91174107
2008 Ford Taurus X SEL AWD White Select Cloth Select Van-Minivan 3.5L V6 DOHC 24V 8GA02972 0 Cylinders - 8GA02972
2008 Chevrolet Colorado Work Truck 2WD Red 2WD Cloth Automatic Truck 3.7L L5 DOHC 20V 88160015 5 Cylinders - 88160015
2007 Lincoln MKX AWD Black FWD Select Automatic SUV 3.5L V6 DOHC 24V 7BJ19708 6 Cylinders - 7BJ19708
2007 Ford Focus ZX4 SES White FWD Cloth Automatic Sedan 2.0L L4 DOHC 16V 7W338481 4 Cylinders - 7W338481
2006 Ford F-250 SD XLT Crew Cab Short Bed 4WD Blue 4WD Cloth Automatic Truck 6.8L V10 SOHC 30V 6EB74619 10 Cylinders - 6EB74619
2003 GMC Yukon XL 1500 4WD Pewter 4WD Leather Automatic SUV 5.3L V8 OHV 16V FFV 3G215239 8 Cylinders - 3G215239
2002 Dodge Ram 1500 Laramie Crew Cab 4WD Charcoal 4WD Cloth Automatic Truck 5.9L V8 OHV 16V 2J194297 8 Cylinders - 2J194297
1999 GMC Yukon SLT 4WD Blue 4WD Leather Automatic SUV 5.7L V8 OHV 16V XJ759101 8 Cylinders - XJ759101
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