3101 Rossville Blvd Chattanooga, TN 37407

Contact Us | (423) 622-3944 - Sales

Secure Credit Application

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Credit Information
Individual Credit - unmarried applicant.
Individual Credit - married applicant.
Joint Credit - with your spouse.
Joint Credit - with another applicant or cosigner who is not your spouse.
NOTE: If applying for Joint Credit with someone other than your spouse, each of you must
complete a separate application.
Personal Information
Full Name
Marital Status:
Social Security #: - -
Drivers License & Exp Date - / /
Date of Birth: / /
Email Address:
Home Phone: eg: 234-555-1212
Cell Phone: eg: 234-555-1212
Street 1:
Street 2:
City / State / Zip:
Date you started living at this address: / /
How long have you lived at this address:
Current Employer
Employer Name:
Phone Number: eg: 234-555-1212
How long have you been working there:
Gross monthly income before taxes:
Additional Income
Additional Monthly Income:
NOTE: Alimony, child support or separate maintenance income need not be revealed if you do
not wish to have it considered as a basis for repaying this obligation.
Spouse's Personal Information
Spouse's Full Name
Spouse's Social Security #: - -
Spouse's Drivers License & Exp Date - / /
Spouse's Date of Birth: / /
Spouse's Email Address:
Spouse's Home Phone: eg: 234-555-1212
Spouse's Cell Phone: eg: 234-555-1212
Street 1:
Street 2:
City / State / Zip:
Spouse's Current Employer
Spouse's Employer Name:
Phone Number: eg: 234-555-1212
How long has your spouse been working there:
Gross monthly income before taxes:
Financial Debts / Obligations
Type of Debt Holder Balance Monthly Payment
Personal References
Relationship Name Address Phone

Check this box to authorize us to share your nonpublic personal information with affiliated and/or nonaffiliated third parties. I understand that in checking this that you may be better able to serve me and that I may receive offers for other products and services that may be of value to me. Please read our privacy policy for more information regarding your rights and how we use the personal information you submit to us.

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This application for credit may be submitted by the Dealer to various financial institutions. Before this application is submitted, the Dealer will disclose to you the name and address of the institution(s) who will receive copies of this application.

By clicking on the 'submit' button below I certify that the above entered information to be true and correct and I hereby authorize you to use this information to perform a credit rating check of my personal credit. I also certify that I am over the age of 18 and am a current U.S. citizen or permanent resident. In addition, I understand that submitting the above information does not represent an obligation by any party to provide credit nor does it obligate me to accept any credit offered.


Wright's Motor Company

Wright's Motor Company
3101 Rossville Blvd
Chattanooga, TN 37407

(423) 622-3944 - Sales
(423) 622-0721 - Fax
Mon: 8:30AM - 4:30PM
Tue: 8:30AM - 4:30PM
Wed: 8:30AM - 4:30PM
Thu: 8:30AM - 4:30PM
Fri: 8:30AM - 4:30PM
Sat: 8:30AM - 3:30PM
Customer Satisfaction is Job One ! ! !