CPI – Point of Loan Origination (POLO) Application

 

If you have any questions while completing this form, please call us at 1-800-624-1669, ext. 104 (Bob) or ext.101 (Chris).

Finance company:

Address:

City:

State/Province:

Zip code:

Dealer name (if different than above):

Address:

City:

State/Province:

Zip code:

Office phone:

Office fax:

Contact person's name:

Contact phone:

Contact email:

Average number of new BHPH deals per month:

Current number of BHPH notes:

Average ACV at the time of sale:

Average loan amount:

Average number of repos per month:

Enter full name of submitter:

Date:

How did you hear about us?
 Agent Referral Conventions Internet Search Email Letter/Mailer Other (specify below)

If through an agent, which one?

If through a convention, which show?

Or, where else did you hear about us from?

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