Credit Application: Please Complete and Sign it. Fax to (503) 297-2586 Att. Finance

Print this page, fill it out completely, make sure you sign it, and fax it to us.

Northwest Investment Cars, Inc. Fax (503)291-4122 Attention Finance Dept.

Individual: I am applying for credit in my own name and relying on my income/assets to repay the loan. Complete and sign the application.

For residents of AZ, CA, ID, LA, NM, NV, TX, WA, WI: Individual using spouse's income/assets to repay loan: I am applying for credit in my own name and relying on my income and/or my spouse’s income/assets to repay the loan. Print two (2) copies of this application. One must be filled out by the applicant and the other must be filled out by the co-applicant.

Joint with spouse or nonspouse: Print two (2) copies of this application. One must be filled out by the applicant and the other must be filled out by the co-applicant.

Applicant's full name: Last Name, First Name, Middle Initial                                   Social Security No.                   Date of Birth                     Home Phone

Home Address                                                             City, State, ZIP.                                                                            Mtg.Pmt. / Rent       How Long

$

Please select one of the following options:

__ Own Home (free & clear)        __ Buying home      __ Mobile           __ Renting       __ Live with Relative     __ Space Rent $_____

Previous Home Address (if at Above less than 2 years)                                                                                                                                           How Long

Employer                                                                                               Employer Address                                                                                 Work Phone

Position Held                                                                                                                                                       How Long                Gross Monthly income

$

Source of other Income                                                                                                                                                                             Monthly

Previous Employer (if less than 2 years on present job                   Previous Employer Address                                       Position                          How Long

Have you filed for bankruptcy in the last 10 years?                                                                                            Have you ever had merchandise repossessed?

         ___ No    ___ Yes                If Yes, Year__________    ____ No    ____ Yes

Everything that I have stated in this application is correct to the best of my knowledge. I understand the retail installment contract /not connected with this application may be submitted for purchase along with a copy of this application to Northwest Investment Cars, Inc. (NWIC). You ("NWIC") are authorized to check my credit and employment history and to answer questions about your credit experience with me. I authorize any person or consumer reporting agency to complete and furnish to you any information it may have or obtain in response to credit inquiries. I understand that you will retain this application and any other credit information you receive whether or not it is approved.

Signature of Applicant __________________________________________ Date______________

PRIVACY NOTICE

In connection with your transaction, Northwest Investment Cars, Inc. may acquire information about you as described in this notice, which we will handle as stated in this notice.

1. We collect nonpublic personal information about you from the following sources:

Information we receive from you on applications or other forms;\
Information about your transactions with us and
Information we receive from a consumer reporting agency.

2. We do not disclose nor do we reserve the right to disclose, any nonpublic personal information about our consumers, customers, or former customers to anyone, except as permitted by law. We may disclose non-public personal information about you, as a consumer, customer or former customer, to non-affiliated third parties as permitted by law.

3. We restrict access to nonpublic personal information about you to employees who need to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

CUSTOMER ACKNOWLEDGEMENT: I acknowledge that I received a copy of this notice on the date indicated below.

Signature of Applicant __________________________________________ Date______________

If joint application is necessary, please print this page again and use it for co-applicants information. Make sure to fill out and sign both applications.