Personal Information

First Name*

Middle Initial*

Last Name*

Phone #*

Marital Status*

Email Address*

Confirm Email Address*

Date of Birth*

Social Security #*

Driver's License #

Driver's License State

Residence Information

Home Address*

Address line 2

City*

State*

Zip Code*

Country*

Time At Current Residence (If less than 2 years, previous address is required)*

Years

Time At Current Residence (If less than 2 years, previous address is required)*

Months

Time At previous Residence (If less than 2 years, previous address is required)

Years

Time At previous Residence (If less than 2 years, previous address is required)

Months

Previous Address

City

State

Zipcode

Rent or Own?

Monthly Payment/Rent*

Mortgage/Leasing Company

Employment Information

Present Employer*

Gross Monthly Income*

Self Employed

Employer Address

Employer City

Employer State

Employer Zip Code

Employer Phone*

Occupation or Job Title*

Time at Company (If less than 2 years, previous employer details are required)*

Years

Time at Company (If less than 2 years, previous employer details are required)

Months

Previous Employer

Years

Previous Employer

Months

Previous Employer Address

Employer City

Employer State

Employer Zip code

Employer phone

Time at Previous Employer

Other Monthly Income Amount

Purchase Information

Purchase Type

Year

Make

Model

Trim

Preferred Contact Method*

Call

Text

In connection with your transaction, Chicago Auto Place may acquire information about you as described in this notice, which we handle as stated in this notice.

We may collect personally identifiable information such as name, postal address, telephone number, e-mail address, social security number, date of birth, etc. This personal information is collected and used by Dealerfire Credit Application staff for the purpose of facilitating a relationship or business transaction.

Our website resides behind a firewall and uses SSL (Secure Sockets Layer, the industry-standard security protocol used to communicate with browsers) to transmit personal information. Data is strongly encrypted during transmission to ensure that personal and payment information is secure. Industry-standard data encryption techniques are used to protect personal information.

Price

We are by appointment only