Contact Info

First Name*

Last Name*

Middle Initial

Date of Birth*

Social Security #*

Drivers License #*

Drivers License State*

Email Address*

Phone #*

Street Address*

Address line 2

City*

State*

Zip Code*

Rent or Own?*

Date of Residency*

This is the date you started living are your current residence

Monthly Rent/Mortgage*

Employment info

Employer Name

Employer Phone #

Job Title*

Date of Employment

This is the date you started your employment

Gross Monthly Income*

Additional Income Source

Additional Income

Tell us about the vehicle you want

Purchase Type*

Year

Make

Model

Trim

Total Loan Amount*

Trade-In?*

Yes

Trade-In Year

Trade-In Make

Trade-In Model

Trade-In Mileage

HOW WOULD YOU LIKE US TO CONTACT YOU?

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We may collect personally identifiable information such as name, postal address, telephone number, e-mail address, social security number, date of birth, etc. This personal information is collected and used by Lamborghini Charlotte Credit Application staff for the purpose of facilitating a relationship or business transaction.

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