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City Loan Application Form

Please answer the following questions as completely as possible, so that we may better serve you.

We accept Applications only If:
Title is In Applicant's name or signed off.
Vehicle must be at least 90% paid off
Applicant must show an ability to repay
the loan pursuant to its terms and conditions


Full Name:
Daytime Tel. Number:
E-mail:
Vehicle Year:
Vehicle Make:
Model:
Loan amount requested:
Are you a California resident?
How did you hear about us?
Verification Code:

Note: Add the numbers and type the answer in the box below. Eg. 5+4=9. Type 9 in the box.