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Sparki Motors
Swaleh Nguru rd Off jomo kenyatta Ave 98252-80100 Mombasa

To : sales@sparkimotors.com

Borrower Information

First Name

Last Name

Home Address

City

State

Zip Code

Months/Years at Residence
Example: 4y/6m
Primary Phone

Alternate Phone

Birth Date
xx/xx/xxxx
Social Security Number
(Your application cannot be processed without your SSN)
eMail Address



Employment Information


Employment Status
(Self Employed, Employee, Unemployed or Other)
Employers Company Name

Gross Monthly Income (Before taxes are taken out)

Employers Street Address

Years & Months of Employment
Example: 4y/6m
Employers City

Employers State

Employers Zip Code

Employers Phone

Your Trade or Occupation

Down Payment Available?
(Yes, No or a $ amount you will be able to put down)

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Your personal comments or any information.


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and hearby give permission to perform credit ckecks:
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