I understand that I am submitting this form for the purpose of securing credit
from Mike Miller Auto Park; I certify that the above information is true and complete to the best
of my knowledge. I further certify that I have attained The Age of Majority. I
authorize Mike Miller Auto Park to check my credit and employment history and to
provide and/or obtain information about credit experiences with me.
2007 West Pioneer Parkway, Peoria, IL 61615 309-693-1222