Secure Finance Application




Applying for an auto loan online is fast, convenient and secure. Simply complete all required fields with your personal and employment information and "Submit" your application.

The form is submitted using an HTTPS form action. All sensitive data is encrypted before transmission and is never sent as clear text.


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

* Driver's License No. and State of Issue:

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:
* 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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Jim Ellis Buick Pontiac GMC, your Atlanta and Chamblee Buick Pontiac GMC dealer
Jim Ellis Buick GMC
5855 Peachtree Industrial Blvd.
Chamblee, GA 30341
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Phone: (678) 392-2616
Email: Contact Us
Fax: (770) 936-4945