2412 Packers Ave
Madison, WI 53704
608-467-2284
Site Menu
Inventory
Financing
Apply Online
Loan Calculator
Visit Us
Reviews
Services
Value Your Trade-In
Vehicle Finder
Our Store
About Us
Contact Us
Meet Our Staff
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
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
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:
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
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
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
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:
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
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
2013 Kia Optima 4dr Sdn LX Pearl White FWD Leather Automatic Sedan 2.4L DOHC GDI 16-valve I4 engine -inc: variable intake system, aluminum block & head Gasoline 1410 4 Cylinders - 1410
2011 Toyota Camry 4dr Sdn I4 Man LE (Natl) Silver FWD Cloth Automatic Sedan 4 Cylinder Engine Gasoline 1394 4 Cylinders - 1394
2011 Toyota Camry 4dr Sdn I4 Man LE (Natl) Gold FWD Cloth 5 Speed Automatic Sedan 4 Cylinder Engine Gasoline 1417 4 Cylinders - 1417
2010 Toyota Prius 5dr HB III (Natl) Silver FWD Cloth Automatic Hatchback 1.8L DOHC 16-valve VVT-i Atkinson-cycle I4 hybrid Hybrid EA 4 Cylinders - EA
2009 Toyota Camry 4dr Sdn I4 Man (Natl) Black FWD Cloth Automatic Sedan 2.4L DOHC VVT-i 16-valve 4-cyl engine -inc: direct injection Gasoline 1425 4 Cylinders - 1425
2008 Toyota Corolla 4dr Sdn Auto LE (Natl) Gold FWD Cloth Automatic Sedan 1.8L DOHC SFI 16-valve VVT-i 4-cyl engine Gasoline 1419 4 Cylinders - 1419
2008 Toyota Camry 4dr Sdn I4 Man LE (Natl) White FWD Cloth Automatic Sedan 2.4L DOHC MPFI VVT-i 16-valve 4-cyl engine Gasoline 1436 4 Cylinders - 1436
2008 Chevrolet Impala 4dr Sdn 3.5L LT Pewter FWD Cloth Automatic Sedan Engine, 3.5L V6 SFI (E85) includes (E85) FlexFuel Gasoline 1413 6 Cylinders - 1413
2007 Toyota Camry Hybrid 4dr Sdn (Natl) Gold FWD Cloth CVT Sedan 2.4L DOHC VVT-i 16-valve aluminum alloy 4-cyl engine Hybrid 1316 4 Cylinders - 1316
2006 Subaru Legacy Wagon Outback 2.5i Auto Green AWD Cloth Select Wagon 2.5L SOHC SMPI 16-valve 4-cyl boxer engine Gasoline 1439 4 Cylinders - 1439
2006 Buick Lucerne 4dr Sdn CXL V6 Black FWD Leather Automatic Sedan Engine, 3.8L 3800 V6 SFI (197 HP [147 kW] @ 5200 rpm, 227 lb.-ft. [308 N-m] @ 3800 rpm) Gasoline 1422 6 Cylinders - 1422
2005 Toyota Prius 5dr HB (Natl) Maroon Select Select Select Hatchback 1.5L DOHC MPFI VVT-i 16-valve 4-cyl engine w/integrated permanent magnet AC synchronous electric motor Hybrid 1324 4 Cylinders - 1324
2001 Honda Accord Sdn EX Auto Gold FWD Cloth Automatic Sedan 2.3L 16-valve VTEC I4 LEV-certified engine Gasoline 1426 4 Cylinders - 1426
2001 Ford Focus 4dr Sdn LX Red FWD Cloth Automatic Sedan 2.0L SOHC SPI I4 engine Gasoline 1409 4 Cylinders - 1409
2000 Honda Accord Sdn 4dr Sdn LX Auto Silver FWD Cloth Automatic Sedan 2.3L VTEC LEV-certified I4 engine Gasoline 1427 4 Cylinders - 1427
Stock Number:
Year:
Make:
Model:
Trim:
Vin:
Mileage:
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:
I hereby consent to receive text messages or phone calls from or on behalf of the dealer or their employees to the mobile phone number I provided above. By opting in, I understand that message and data rates may apply. This acknowledgement constitutes my written consent to receive text messages to my cell phone and phone calls, including communications sent using an auto-dialer or pre-recorded message. You may withdraw your consent at any time by texting "STOP".
Submit Credit App
Dealer Car Search Login
Copyright 2021 |
Sitemap
Capital Auto Clinic LLC
2412 Packers Ave,
Madison,
WI
53704
608-467-2284
https://capitalautoclinic.com
Text Us
Text us
×
Close
First Name
Last Name
Mobile Phone
Comments
ACKNOWLEDGMENT AND CONSENT:
I hereby consent to receive text messages or phone calls from or on behalf of the dealer or their employees to the mobile phone number I provided above. By opting in, I understand that message and data rates may apply. This acknowledgement constitutes my written consent to receive text messages to my cell phone and phone calls, including communications sent using an auto-dialer or pre-recorded message. You may withdraw your consent at any time by texting "STOP".