Loan Application

Applicant Information

Which vehicle are you interested to finance?

First Name (as appears on Driver Licence)

Middle Name

Last Name (as appears on Driver Licence)

Phone Number

Your Email

Date of Birth (yyyy/mm/dd)

S.I.N. (numbers only, no space)

Marital Status:
SingleCommon-lawMarriedSeparatedDivorced
Have you declared bankruptcy?
YesNo
My Credit is:
GoodNot so goodNo credit history

Applicant Address:

Street Address

City/Town

Province

Postal Code

How long have you lived at this address? (yrs/mths)

Residence:
Own with mortgageOwn free and clearRentLive with parents
Monthly Payment

Mortgage Provider (Financial Institution)

Total Mortgage amount owing

Current Home Value

Previous address (fill in only if less than 1yr at current address)

FINANCIAL INFORMATION?

Current Employer

Occupation

Duration of employment (yrs/mths)

Gross Income per Month (before deductions)

Employer's Phone Number

Employer's Street Address

Employer's City/Town

Employer's Province

Employer's Postal Code

If employed there for less than 1yr, please provide previous employer's information:

Previous Employer's Phone Number

Previous Employer's Address

BY SUBMITTING THIS APPLICATION I AUTHORIZE AND CONSENT TO THE USE BY THE CAR SHOP OF MY PERSONAL INFORMATION, FOR THE PURPOSE OF INITIATING A CREDIT CHECK, PROCESSING AND POTENTIALLY OBTAINING A CAR LOAN FROM A LENDER.

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