Request Financing

By emailing us ahead of time, we can process your finance application prior to your visit.  We strive to make your experience a positive one, so let us take care of the paperwork while you search for your next car!

If you are currently working with one of our sales professionals please indicate their name in the notes section.


If you prefer, you can also call us at 1-800-309-5138 and one of our friendly sales members will be more than happy to help you out!
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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:

Employment Information

Employer:
Occupation:
Monthly Income:
Time On Job:
Business Phone:
Address:
City: State:
Zip:

Loan Information

Applicant Type:
Amount Required: Loan Term:
Down Payment: Trade-In:

Vehicle Information

Year: Miles:
Make: VIN:
Model:

Other Income

Source: Monthly Income:

Additional Information

* Drivers License # & Comments:
* 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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Heritage Mazda
1500 W Pioneer Parkway
Peoria, IL 61615
Site Map
Sales Department: 866-414-0662
Email: Contact Us
Fax: (309) 693-2251