Credit Application, Automotive

Dealership Information  

*Indicates Required fields

*Dealership Name:

* E-Mail Address:
(e.g. jdoe@itlife.ca)


Applicant Information


*Title:

*First Name:

Initial:

*Last Name:

*Birth Date:

*SIN Number:

E-Mail Address:
(e.g. jdoe@itlife.ca)

*Phone Number:

*Address

* Address:
Address 2:
*City:
* Province:
*Postal Code:

Applicant Identification


*Drivers License #:

*Expiry Date:

Applicant Employment Information


*Employer Name:

*Start Date:

*Income per month:
(before taxes and other deductions)

Previous Employer (if less than 1 years ago)

Employer Name:

Start Date:

Income per month:
(before taxes and other deductions)

Applicant Housing Information

*Housing Status:

Rent/Mortgage Payment: $ per month

Applicant Financial Information

*Have you Declared Bankruptcy in the last 7years?:

If yes, Date Discharged:

*Have you ever had a repossession? :

*Bank Name:

Co-Applicant Information


Title:

First Name:

Initial:

Last Name:

Birth Date:

SIN Number:

Drivers License #:

E-Mail Address:
(e.g. jdoe@itlife.ca)

Phone Number:

Address:

Co-Applicant Employment Information

Employer's Name:

Start Date:

Income per month:
(before taxes and other deductions)

Digital Signature:

By clicking on "Submit your Credit Application", you affirm that the information you have given in this Application is true and complete and that you have not withheld any information. We will rely on the information you have given us to decide on your Application. You authorize us to give to, obtain, verify, share and exchange credit and other information about you and with others, including credit bureaus, and other persons with whom you may have financial dealings as well as any other person as may be permitted or required by law. You also expressly waive your right, where permitted by law, to receive a copy of any Financial Statements or Financing Change Statements registered under the Personal Property Security Act as a result of a loan made by us to you or any renewal or discharge thereof.