Ph(919) 432-1200, Fax(919) 734-5955
Instructions
  1. If you are married, and you are individually applying for credit, your spouse cannot be required to provide credit information or sign this Application, and your credit worthiness will be considered on your merit alone.

  2. Fields marked with * are required.

Personal Loan
  1. $

  2. Yes No
    $

  3. Yes No



Applicant Information







  1. Own Rent
    Yrs. Mos.



Employment and Income Information


  1. Yrs. Mos.


Co-Applicant Information







  1. Own Rent
    Yrs. Mos.



Co-Applicant Employment and Income Information


  1. Yrs. Mos.


Other Information
  1. Yes No

Certification Statement
  1. General Application Disclosure:

    *I am providing this Customer's Statement with an Application for Credit ("Application") for the purpose of obtaining credit through North State Acceptance LLC, or through the selling dealer, on behalf of myself, or on behalf of others whose credit I endorse, co-sign, or guarantee. I certify that the foregoing information has been supplied truthfully, accurately, and voluntarily, and therefore, authorize North State Acceptance LLC and/or selling dealer to investigate my credit worthiness, credit history, and financial responsibility through any credit bureau, or by an other reasonable means, including direct contact with past or current creditors, or any other references I have provided herein. I also authorize North State Acceptance LLC, or selling dealer, to answer inquiries from others seeking credit experience about me. I understand that false and misleading statements in my application may cause any loan to be in default. I agree that this application shall be the property of North State Acceptance LLC whether or not the loan is approved. I understand that it is a crime to willfully and deliberately provide incomplete or incorrect information to obtain credit. I understand that upon request, I will be provided the name and address of any credit bureau from which North State Acceptance LLC received a credit report. By signing below, I understand this Customer's statement is being provided to North State Acceptance Corporation, or selling dealer, to be used in deciding whether to grant or continue credit*

  2. Important Information About Account Opening Procedures:

    *Federal law requires North State Acceptance LLC, to obtain, verify and record information that identifies each person who requests to open an account prior to account opening.

  3. What this means to you:

    *When you apply for credit, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver's license and other identifying documents. Failure to provide the required information may result in denial of your request to open an account.

Notice
  1. Exercising in good faith your rights under the Consumer Credit Protection Act, you will not: be discouraged to apply, denied credit, offered less favorable rates or terms than someone with similar qualifications or have your account closed based on race, color, national origin, sex, marital status, age, being a recipient of any public assisted program or any other protected class.

  2. You are required to have physical damage insurance to cover any loss or damage to the vehicle you are purchasing for the term of the financing contract. You may choose your insurance agent or insurance company provided that the insurance company is reasonably acceptable to us and that the physical damage insurance purchased adequately covers the vehicle.

Review and Submit
  1. Applicant's Authorization by Signature

    If the 'Applicant Agrees' box is not checked, this process is cancelled and the information is not saved. An application will not be submitted to North State Acceptance, LLC .


  2. Please review your application. When complete, please click SUBMIT to finish your application.