Prefer to speak to us over the phone? 
Please call 800-614-0231

Fill out this short form to apply for a loan! By filling out this form, you are authorizing us to run a credit check on you. When you click the Send button, your information will be submitted securely. It will not be accessible by any outside parties and will only be accessed by our Finance Department.

Click here to return to the homepage

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.


  This Page Is Submitted Securely
Wagner Buick Pontiac GMC | new Buick, GMC and Pontiac dealership in Belleville and serving Collinsville
Wagner Buick Pontiac GMC - Belleville, Illinois
3800 West State Route 15
Belleville, IL 62226
Site Map | Privacy Policy | Terms of Use
Phone: 800-614-0231
Email: Contact Us
Fax: (618) 234-0285