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Your Information

First Name ^*

Last Name ^*

Preferred Contact Method*

Email ^*

Phone ^*

Zip Code ^*

I understand I do not have to consent as a condition of purchase or to receive any services. By checking this box, I agree Genesis, Genesis retailers and/or their vendors may use the number provided to make telemarketing calls or texts via automated technology. Carrier charges may apply.

What vehicle are you interested in applying for?

Vehicle Condition *

Year*

Make*

Model*

Trim (Optional)

VIN (Optional)

You agree to receive texts from us. (No purchase necessary.) No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All other categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.

By submitting your information, you agree to the sharing of your information between Genesis Motor America and its authorized retailers.

Additional Information

Finance Type

Personal Information

Date Of Birth *

Social Security Number *

Driver's License Number *

Driver's License State *

Residence Information

Address *

City *

State *

ZIP / Postal Code *

Residence Status *

Monthly Rent / Mortgage *

Time at Residence *

Employment Information

Employer Class

Employer *

Employer City *

Employer State *

Work Phone *

Position *

Length of Employment *

Pay Frequency

Expected Monthly Salary *

Other Monthly Income

Other Monthly Income Source

Former Employer * Only required if time at current employer is less than 2 years

Employer Class

Employer *

Employer City *

Employer State *

ZIP / Postal Code *

Work Phone *

Position *

Length of Employment

Gross Monthly Income *

Reason for Leaving (optional)

Are you applying with a co-applicant?

Yes

Additional Comments

I certify that this application is for the purposes of obtaining an auto loan. By submitting this application, I authorize the dealer to request credit reports and verify information for me and any joint applicant. I also authorize the dealer to contact third parties and when necessary share information provided by me and any joint applicant in connection with processing my loan request. I have read and agreed to the Privacy Policy and Terms of Use, links for which are located on the bottom of this website.

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Apply For Financing

Your Information

What vehicle are you interested in applying for?

Additional Information

Personal Information

Residence Information

Employment Information

Former Employer * Only required if time at current employer is less than 2 years

Are you applying with a co-applicant?

Genesis of Winston-Salem

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