Goodwin Honda, Civic, Part, Accord, Prelude, CRX, Odyssey, Accessory, S2000, Car, Dealer

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Use this form to qualify for financing approval. If you prefer, you may print this form and fax it to us at (803)469-2606.

Initial Privacy Notice (for Online Credit Application)

Dealership (We)
Goodwin Automall
2700 Broad Street
Sumter, SC 29150
803-469-2525

Customer (You)
Name:
Address:
Telephone:

In connection with your transaction we may obtain nonpublic personal information about you and that information is handled as stated in this notice.

1. We collect personal nonpublic information about you from the following sources:
   a. Information we receive from you on an application for credit or other similar forms.
   b. Information about your transactions with us and others; and,
   c. Information we receive from a consumer-reporting agency.

2. Please be aware that it is our policy to disclose the above nonpublic personal information to only those companies that perform marketing services on our behalf or to other financial institutions with which we have joint marketing agreements.

3. We do not disclose any nonpublic personal information about you to anyone except permitted by law.

4. Further, we restrict access to your nonpublic personal information to only those employees who need to know that information to provide products or services to you. Employees cannot use your information for any other purpose. For your safety, we maintain physical, electronic and proceddural safeguards that comply with federal regulations to further guard your nonpublic personal information.

Customer Acknowledgement:
By entering my name below, I'm acknowledging that I have read and understood the above information.
Your Name:

Personal Information:

Name, First M. I. Last Suffix
Birthdate: Month/Day/Year / / Social Security # --

Email Address

Address:

Street Address
City State Zip -
Home Phone Landlord/Mortgage Holder
Lenth of Residence: YearsMonths Monthly Payment
Monthly Payment for

Previous Address:

Street Address
City State Zip -

Lenth of Residence: YearsMonths

Employment Information

Employed by: Employer
Street Address
City State Zip -
Work Phone Trade/Occupation
Monthly Income (gross): Length of Employment: Years Months

Previous Employer:

Previous Employer
Street Address
City State Zip -
Length of Employment: Years Months

I certify that the above information is true and correct to the best of my knowlege. I also understand that by signing and/or submitting this application, I am authorizing Goodwin Buick, Inc. to pull a credit report.

Signature: Date

Goodwin Honda
2700 Broad St.
Sumter, SC 29150

Phone		(803) 469-2595 or Toll Free 1-866-Goodwin
Fax		(803) 469-2606
Email		goodwinauto@ftc-i.net

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