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Black Modern Car

Credit Application

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(347) 215-2290

158 Main Street Staten Island NY 10307

Applicant Information

Employment Information

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I (we) certify that the above information is complete and accurate. I (we) authorize an investigation of my (our) credit and employment history, and the release of any related information. I (we) authorize you to exchange credit information with other in connection with this application. I (we) have no outstanding obligations except as shown in this application, an no undisclosed lawsuits or judgments are entered against me (us).

Car Dashboard
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