* First Name:
* Last Name:
Age:
Birth Date: 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 - January February March April May June July August September October November December - 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Martial Status: Married Single Divorced Other
* Address:
(line 2):
* City:
* Province: Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan
* Postal Code:
* Daytime Phone:
Evening Phone:
* Email:
Social Insurance Number:
* Present Employer:
Occupation:
* Length of Current Employment: Years Months
Previous Employer:
Length of Previous Employment: Years Months
* Gross Monthly Income:
Monthly Rent Payment:
Monthly Mortgage Payment:
Length at Current Residence: Years Months
* Have you declared bankruptcy within the past 7 years? Yes No
* Have you ever had a vehicle repossessed? Yes No
If necessary, do you have a co-signer for your financing? Yes No
Co-applicant Name: (optional)
Co-applicant Address: (optional)
Co-applicant Address (line 2): (optional)
Co-applicant Phone: (optional)
Co-applicant SIN: (optional)
Co-applicant Age: (optional)
Co-applicant Birth Date: 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 - January February March April May June July August September October November December - 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 (optional)
Co-applicant Present Employer: (optional)
Co-applicant Occupation: (optional)
Co-applicant Gross Monthly Income: (optional)
Please rate your credit: Good Credit Average Credit No Credit Bad Credit
* Vehicle desired #1:
Vehicle desired #2:
Vehicle desired #3:
Down payment amount:
Plan to purchase / lease a vehicle within: 1 Week 1 Month 3 Months
Have trade-in vehicle: Yes No
Trade-in vehicle description:
Comments:
I certify that each of the statements made and answers given in this credit application are true and correct and is made for the purpose of inducing the financing of the purchase of a motor vehicle. I authorize the obtaining of a consumer report to be used in evaluating this application and the obtaining and exchanging of credit information from and with other creditors and consumer reporting agencies.
