501 E Beecher St
Adrian, MI 49221
517-263-1148
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
Blog
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
2025 Nissan Rogue AWD SV Black Wagon 1.5L DOHC 12-Valve 3-Cylinder DI Turbocharged Engine -inc: idle stop/start Gasoline 5054 3 Cylinders - 5054
2024 Chevrolet Blazer FWD 4dr LT w/2LT Red SUV Engine, 2.0L Turbo, 4-cylinder, SIDI DOHC with Variable Valve Timing (VVT) with Stop/Start (228 hp (170 kW) at 5000 rpm, 258 lb-ft of torque [350 N-m]) - 5046
2024 Buick Envista FWD 4dr Sport Touring Copper FWD Leather Automatic Crossover 3 Cylinder Engine 4946 0 Cylinders - 4946
2023 Chrysler Pacifica Touring L FWD Gray Van-Minivan 3.6L V6 24V VVT UPG I w/ESS Gasoline 5035 6 Cylinders - 5035
2022 Kia Forte LXS IVT Gray Sedan 2.0L 4-Cylinder MPI 16V DOHC w/Dual CVVT Gasoline 5065 4 Cylinders - 5065
2021 Chevrolet TrailBlazer FWD 4dr RS White SUV Engine, ECOTEC 1.3L I3 Turbo DOHC SIDI with Variable Valve Timing (VVT) (155 hp [115 kW] @ 5600 rpm, 174 lb-ft torque [236 N-m] @ 1600 rpm) Gasoline 5 - 5055
2020 Hyundai Santa Fe Limited 2.0T Auto AWD Black AWD Leather Automatic Wagon 2.0L Turbo GDI E-CVVT 16-Valve 4-Cylinder -inc: Idle Stop & Go (IGS) Gasoline 5031 4 Cylinders - 5031
2020 Ford Ranger LARIAT 4WD SuperCrew 5' Box Gray Truck 2.3L EcoBoost -inc: auto start-stop technology Gasoline 5056 4 Cylinders - 5056
2018 Mitsubishi Outlander Sport SE 2.4 CVT Black Wagon 2.4L MIVEC DOHC 16-valve 4-Cylinder Gasoline 5061 4 Cylinders - 5061
2018 Chevrolet Colorado 4WD Crew Cab 128.3" Work Truck Black Truck Engine, 3.6L DI DOHC V6 VVT (308 hp [230.0 kW] @ 6800 rpm, 275 lb-ft of torque [373 N-m] @ 4000 rpm) (Standard on Crew Cab models.) - 5064
2015 Kia Soul 5dr Wgn Auto + Black Wagon 4 Cylinder Engine Gasoline 5043 4 Cylinders - 5043
2014 Chevrolet Equinox FWD 4dr LT w/1LT Black Wagon Engine, 2.4L DOHC 4-cylinder SIDI (Spark Ignition Direct Injection) with VVT (Variable Valve Timing)(182 hp [135.7 kW] @ 6700 rpm, 172 lb-ft [232. - 5066
2013 Ford Fusion 4dr Sdn SE FWD Red Sedan 2.5L i-VCT I4 engine Gasoline 5063 4 Cylinders - 5063
2013 Chrysler 200 4dr Sdn Limited Gray Sedan 3.6L VVT 24-valve V6 engine Gasoline 5034 6 Cylinders - 5034
2012 Chrysler 200 4dr Sdn Limited Burgundy Sedan 2.4L DOHC SMPI 16-valve I4 dual VVT engine (REQ: NAA Emissions) Gasoline 5042 4 Cylinders - 5042
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:
By checking this box, you expressly consent to receive customer care text messages and/or phone calls to the number provided from or on behalf of Jerry Moore Auto Exchange or their employees in response to your inquiry. By opting in, you understand no mobile information will be shared with third parties or affiliates for marketing or promotional purposes. Message frequency varies per user. Message and data rates may apply. You may withdraw your consent at any time by texting "STOP" or "HELP" for help. See our
Privacy Policy
for more information.
Submit Credit App