Wilhelm Chevrolet Buick Pontiac GMC Cadillac
Call (701) 252-2950 or 1-800-450-2950

Request Financing
Thank you for taking the time to send us this form.  If you have any questions at all regarding this finance form, please call me at (877) 826-0689 and ask for Steve Jaskovick.

Loan Information

* Applicant Type:
* Amount Required: * Loan Term:
* Down Payment: * Trade-In:

Vehicle Information

Year: Miles:
Make: VIN:
Model:

Employment Information

* Employer:
* Occupation:
* Monthly Income:
* Time On Job:
* Business Phone:
* Address:
* City: * State:
* Zip:

Other Income

Source: Monthly Income:

Contact Information

* First Name: * Last Name:
* Email: Home Phone:
* Day Phone: Fax:
Cell Phone: * Preferred Contact:
* Address:
* City: * State: * ZIP Code:

Applicant Information

  Format: xxx-xx-xxxx   Format: MM/DD/YYYY
* Soc. Sec. No.: * Date of Birth:
* Residence Type: * Monthly Payment:
* Years At Residence:

Additional Information

Message Text:
* These fields are required
I certify that I have provided true and accurate information in this form. By submitting this form, I authorize the dealer to begin a credit investigation, to process my application, and to forward my application to lenders, financial institutions, or other third parties in order to process my application.


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Wilhelm Chevrolet Buick Pontiac GMC Cadillac
305 Business Loop West
Jamestown, ND 58401
P: (877) 826-0689
Email: Contact Us
Fax: (701) 252-8094
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