GAP Application

GAP Application













Type of Institution - Check all that apply

  Commercial Bank

  Finance Company

  Savings Bank

  Credit Union


Instrument - Check all that apply


  Balloon Loan



Portfolio Information












Origination Source



Geographic Origination - Four Largest States





Portfolio Information

   YTD Last Year 2 Years Ago
 # Instruments Made
  # Instruments Outstanding
  Max Instrument Amt.
  Avg. Instrument Amt.
  Avg. Sales Price as % of MSRP/NADA Retail
  Avg. Down Payment as % of Sales Price
  Min Down Payment as % of Sales Price
  Avg. Original Term (months)
  Avg. Actual Term (months)
  Maximum Original Term
  Avg. APR
  # of Total Losses Reported To You
  # of Thefts Reported To You
  Avg. Deficiency if Insurance Settlement is Insufficient to pay off the Instrument

Residual Value Publication Used - (If Lease or Balloon Loan)




  Black Book




Type of Coverage Requested

  Blanket Non-Reinsured

  Blanket Reinsured

  Voluntary Non-Reinsured

  Voluntary Reinsured



If reinsured, do you own a reinsurance company that you wish to use?  

Point of Sale

  At Applicant's Locations

  At Dealer



Insurance Information

Do you require that the borrower carry adequate insurance naming you as the loss payee?

Do you require written evidence of this insurance?

Is insurance monitoring now provided by a service company?



Your Current GAP Insurance

Do you currently have GAP insurance on your portfolio?


Is it reinsured?




  Optional To Borrower

Existing GAP Insurance Results Summary

   YTD Last Year 2 Years Ago
 Premium Paid to Carrier
  Losses Paid By Carrier
Excluding Loss Adjustment Expenses

Agent Information