Title, Consumer & Auto Loan Application Form

**You must reside in Georgia, Alabama, or South Carolina in order to submit an application.

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Thanks for choosing 1-800-New-Rate!

Hello, one of our friendly representatives will be contacting you shortly to help you get the cash you need. If you wish, you may complete the full online application below to speed up your loan approval process. We look forward to speaking with you soon.

Name: First Last
Phone: Phone
Email: Email
Zip Code: Zip Code

Vehicle: Year Make Model
Title Loan Trapped? Select
Clear Car/Truck Title? Select
Application Status: Pending
Title Loan Application
Complete the following application to apply for a Title Loan online.
Auto Loan Application
Complete the following application to apply for an Auto Loan online.
Consumer Loan Application
Complete the following application to apply for a Consumer Loan online.
I. Personal Information
Name*
First Last
Social Security Number*
Date of Birth*
Primary Phone*
Secondary Phone (optional)
Email*
Enter Email Confirm Email
Address*
Street Address City ZIP
State*
State
Mortgage / Landlord Name
Mortgage / Landlord Phone
Mortgage / Landlord Info
State ZIP
How long at residence?
Have you ever declared Bankruptcy?*
- Yes
- No
Chapter 7 or 13?
Date of Bankruptcy Discharged or Dismissed?
MM slash DD slash YYYY
Have you ever had property repossessed?*
- Yes
- No
Date of Repo
MM slash DD slash YYYY
Co-Applicant Personal Information
- Check to add co-applicant personal information
Co-Applicant Personal Info
Co-Applicant Name*
First Last
Social Security Number*
Phone*
Email*
Enter Email Confirm Email
Address*
Street Address City ZIP
State*
Mortgage / Landlord Name
Mortgage / Landlord Phone
Mortgage / Landlord Info
State ZIP
How long at residence?
MM slash DD slash YYYY
Has co-applicant ever declared Bankruptcy?*
- Yes
- No
Chapter 7 or 13?
Date of Bankruptcy Discharged or Dismissed?
MM slash DD slash YYYY
Has co-applicant ever had property repossessed?*
- Yes
- No
Date of Repo
MM slash DD slash YYYY
II. Employer Information
Occupation
Employer*
Employer Supervisor*
Employer Phone Number*
Address
Street Address City State ZIP
Hourly Wage / Salary
How long on the job?
Full or Part Time?
Additional Income
Co-Applicant Employer Information
- Check to add co-applicant employer information
Co-Applicant Employer Info
Occupation
Employer*
Employer Supervisor*
Employer Phone Number*
Address
Street Address City State ZIP
Hourly Wage / Salary*
How long on the job?*
Full or Part Time?*
Additional Income*
III. Vehicle Information
Vehicle Make*
Vehicle Model*
Vehicle Year*
Vehicle Mileage*
IV. Title Information
Do you currently owe a title pawn company for this vehicle?*
What is the name of the title pawn company?
If yes, what is your current monthly payment?
How much do you still owe on your title pawn loan?
How long have you been trapped in a title pawn loan?
Date of the last interest payment that you paid?
MM slash DD slash YYYY
What is the due date of your next payment?
MM slash DD slash YYYY
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How did you first hear about us?*
Schedule a call back time*
Select the preferred time you will be available to speak with 1-800-New-Rate to discuss the fastest way to receive your loan.
Privacy Policy*
Services are available through Motors Acceptance Corporation and herein referred to as “company”.
- As part of our finance business, we obtain certain “nonpublic personal financial information” about you. Which for ease of reading we will refer to as “Information” in this notice. This Information includes Information we received from you on your application or other forms, Information about your transactions with us, our affiliates or others, and Information we receive from consumer reporting agency.
- We restrict access to the Information to authorized individuals who need to know this Information to provide service and products to you.
- We maintain physical, electronic, and procedural safeguards that protect your information.
- We do not disclose this Information about you or any former customer to anyone except as permitted by law.
- Employees share this Information outside the company only as authorized by you or for a specific business purpose.
- The law also permits us to share this Information with companies that perform marketing services for us, or other financial institutions that may service or purchase your retail installment sales contact.
We may also share other types of information with our affiliates including finance companies or automobile companies. This Information may be financial or other personal Information such as employment history and it may be directly related to our transaction with you. Consistent with the Fair Credit Reporting Act, our standard authorizations permit us to share this Information with our affiliates.
Privacy Disclaimer*
- I / we have received a copy of the company's privacy notice as required under the Gramm-Leach-Biley Act. I / we have read and understand the company's privacy policy.
Disclosure Agreement*
Services are available through Motors Acceptance Corporation and herein referred to as “company”.

You authorize selling dealer or Finance Company to initiate a credit investigation based upon the above information, which information has been voluntarily provided by myself, and warrants the truth and accuracy of this information. You authorize the “COMPANY” AND OR THE Financial Institutions with whom it deals, to gather whatever credit and employment history they consider necessary and appropriate, including your consumer credit report. You understand that “COMPANY” and/or any Financial Institution with whom it shares your information will retain this information whether or not your application is approved. You agree that you will notify “COMPANY” and any applicable financing institution of any changes of name, address or employment prior to consummating your loan. You understand that you may be required to provide verification of representations made in this application and as such you may be required to provide additional documentation which includes, but is not limited to, W-2s, income tax returns, utility bills, financial statements and pay check stubs. You agree to provide, upon request such additional documentation as may be necessary to process this application. You agree and understand that this information may be submitted to Financial Institutions in order to obtain a credit approval. You further warrant that a bankruptcy proceeding is neither presently in progress nor anticipated.
Application Disclosure & Agreement*
- I / we have read and understand the company’s Application Disclosure and Agreement
Signature of Applicant*
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Online Application

Title Loan Application

Auto Loan Application

Consumer Loan Application

I. Personal Information

Co-Applicant Personal Info

II. Employer Information

Co-Applicant Employer Info

III. Vehicle Information

IV. Title Information

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