Contact Info

First Name*

Last Name*

Email Address*

Phone #*

Street Address*

Address line 2

City*

State*

Zip Code*

Date of Residency

This is the date you started living at your current residence

Monthly Rent/Mortgage

Social Security #*

Date of Birth*

Employment info

Occupation or Job Title

Hours Per Week*

Employer Name*

Employer Phone #

Hourly Rate

Gross Monthly Income*

Gross Yearly Income

Date of Employment

Co-Applicant Contact Info

First Name

Last Name

Day Phone

Evening Phone

Street Address

Address Line 2

City

State

Zip Code

Date of Residency

Monthly Rent/Mortgage

Social Security

Date of Birth

Co-Applicant Employment Info

Occupation or Job Title

Hours Per Week

Employer Name

Employer Phone Number

Hourly Rate

Gross Monthly Income

Gross Yearly Income

Date of Employment

Tell us about your Trade-in

Trade In?Trade In?

yes

Trade-In Year

Trade-In Make

Trade-In Model

Trade-in Trim

Trade-In Mileage

Tell us about the vehicle you want

Total Loan Amount*

How should we contact you?*

I agree to give permission for the above applicant(s) Consumer Credit Report(s) to be obtained, at no cost to me, in order to help determine the types and extent of financing which are available*

[Optional] I consent to receiving telemarketing calls or texts at this number using an automatic telephone dialing system by, or on behalf of, Hyundai and its authorized dealers. I understand I do not have to consent in order to submit a lead, receive contact from the dealer, or purchase any products or services. Carrier charges may apply.

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By submitting your information, you agree to the sharing of your information between Hyundai Motor America and its authorized dealers.

In connection with your transaction, Cocoa Hyundai may acquire information about you as described in this notice, which we handle as stated in this notice.

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 Cocoa Hyundai Credit Application staff for the purpose of facilitating a relationship or business transaction.

Our website resides behind a firewall and uses SSL (Secure Sockets Layer, the industry-standard security protocol used to communicate with browsers) to transmit personal information. Data is strongly encrypted during transmission to ensure that personal and payment information is secure. Industry-standard data encryption techniques are used to protect personal information.

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