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FAIR CREDIT REPORTING ACT DISCLOSURE:

This application for credit may be submitted by the Dealer to various financial institutions. Before this application is submitted, upon request, 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 above 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.

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PAYMENT CALCULATOR

Please understand that using the above payment calculator does not represent an obligation by any party to provide credit nor does it obligate you to accept any credit offered. Ultimately, any credit, if offered, is usually calculated based on your credit worthiness, amount of down payment, negotiated price, trade-in allowance and any extras or discounts that affect the final purchace price and what your payment amount will be.

Brakeman Motors
Brakeman Rd
Painesville, OH 44077
(216) 310-2934 - Main

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Selling Price :
Down Payment :
Loan amount :
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Full Name		Daytime Phone
E-Mail Address		Evening Phone

VIN		Miles
Year		Engine
Make		Trans
Model		Condition

Offer Amount
Full Name
Email
Daytime Phone
Evening Phone
Are you pre-approved by your bank?		yes no
If so, how much are you pre-approved for?
Do you want us to get you financed?		yes no
Do you have a trade-in?		yes no
Do you still owe money on your trade?		yes no
If so, how much do you owe?

Engine Needs Work	Engine Smokes	Good Brakes	Clear Title
Trans Needs Work	Will Pass Emmissions	Good Tires	Lien on Title
Car Not Running	Won't Pass Emmissions	Will Pass Inspection	Missing Title
Body Needs Work	Emmissions Exempt	Won't Pass Inspection