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Financial Form

Financial Form

First Name*
Middle Initial
Last Name*
Street Address*
City*
State*
Zip*
Preferred Email Address*
Daytime Phone Number*
Mobile*

Date of Birth*

Social Security Number (SSN)*
Employer Name*
Employer Phone*
Job Title*
Living Arrangements*

Monthly Rent/Mortgage Payment*
Length of Time at Current Address*

Length of Employment*

Annual Income*
Joint Application

Applicant Additional Income Information
Complete "Other Income" and "Source of Other Income" only if you want this income considered for repayment. Enter monthly amount. Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Other Income Amount (Monthly)
Other Income (Source)
Please include any additional information or options that you would like

Joint Applicant Personal Information

First Name*
Middle Initial
Last Name*
Relationship to Applicant*
Street Address*
City*
State*
Zip*
Preferred Email Address*
Daytime Phone Number*
Mobile*
Date of Birth*

Social Security Number (SSN)*
Employer Name*
Employer Phone*
Job Title*
Living Arrangements*

Monthly Rent/Mortgage Payment*
Length of Time at Current Address*

Length of Employment*

Annual Income*

Joint Applicant Additional Income Information

Complete "Other Income" and "Source of Other Income" only if you want this income considered for repayment. Enter monthly amount. Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Other Income Amount (Monthly)
Other Income (Source)
Please include any additional information or options that you would like
By clicking on "Submit Credit Application", I acknowledge and declare that I have read and agree with the Application Disclosure above. I certify that I have provided complete and true information in this application.

You agree with the storage and handling of your personal and contact data by this website.

✔ Make & Model: Mazda Axela Sport 22XD Proactive
✔ Year: 2018
✔ Mileage: 114,288 KM
✔ Chassis No.: BM2AS-101388
✔ Model Code: LDA-BM2AS
✔ Engine: 2.2L Turbo Diesel (SH Engine)
✔ Transmission: Automatic
✔ Drive Type: 4WD
✔ Fuel Type: Diesel
✔ Body Type: Hatchback
✔ Exterior Color: Gray
✔ Seats: 5-Seater
✔ Steering Position: Right-Hand Drive
✔ Fuel Efficiency: 11.762 km/L

✅ 4WD System – Perfect for all road conditions
✅ Powerful 2.2L Diesel Engine – High torque & fuel efficiency
✅ Automatic Transmission – Smooth & effortless driving
✅ Spacious 5-Seater Interior – Comfortable & stylish
✅ Sporty Hatchback Design – Sleek & modern look
✅ Reserve Before Arrival for KSH 2.15M – Save KSH 100K!