En Español * Indicates Required Fields Personal Information *First Name Middle Initial *Last Name Suffix Select Value Jr Sr II III IV *Date Of Birth *Social Security Number Residential Information *Address *City *State Select Value Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *Zip Code *Cell Phone Number *Email Address *Do you rent or own your home? Select Value No Rent Live With Others No Rent Live With Parents Renting (Long Term Lease) Renting (Short Term Lease) Owner/Buying *How long have you lived at your current residence? Select Value 0 - 6 Months 7 - 12 Months 13 - 35 Months 3 - 5 Years Over 5 years *How many times have you moved in the last 3 years? Select Value 4 Residence Changes 3 Residence Changes 2 Residence Changes 1 Residence Change No Residence Changes *How long have you lived in the Texas Panhandle? Select Value 0 - 12 Months 1 - 3 Years 4 - 22 Years 23 - 45 Years Over 45 Years Employment Information *Employer Name *Occupation *Duration (Years) *Duration (Months) *Monthly Income Other Income *How long have you worked at your current job? Select Value 0 - 6 Months 7 - 12 Months 13 - 35 Months 3 - 5 Years Over 5 years *How many job changes have you had in the last 2 years? Select Value 4 Job Changes 3 Job Changes 2 Job Changes 1 Job Change No Job Changes Vehicle Finance Information Desired Down Payment Desired Monthly Payment Desired Term (months) *How many car loans have you paid in full in last 12 years? Select Value Have never financed a car 1 car 2 cars More than 2 cars *Car repossessions in the last three years? Select Value 1 or more within 6 months of loan date 2 or more in the last 3 years None in the last 3 years Never financed a car Privacy Notice Terms and Conditions By clicking the I Agree checkbox and Submit, I consent to have my credit file accessed for purposes of prequalifying for a vehicle loan. I agree to the Privacy Notice, Terms and Conditions and I acknowledge I may be contacted by Titan Motors. I understand that I might not prequalify depending on the prequalification criteria. I Agree