| Personal Information |
| |
| Name (First, Middle Initial, Last) |
|
| Birth Date |
|
| Social Insurance Number
|
|
| |
| |
| Residential Information |
| |
| Present Address |
|
| City, Province |
|
| Postal Code |
|
| Monthly Rent or Mortgage Payment |
|
| Time at Residence |
Years Months |
| Home Phone Number (with Area Code) |
|
| Cell Phone Number (with Area Code) |
|
| E-mail Address (will be kept confidential) |
|
| Previous Address (if less than 2 years) |
|
| City/Province |
|
| Postal Code |
|
| Time at Residence |
Years Months |
| |
| Employment Information |
| |
| Employer |
|
| Employer Phone Number |
|
| Job Title or Occupation |
|
| Time with Current Employer |
Years Months |
| Monthly Income (Before Taxes and Deductions) |
|
| Previous Employer (if less than 2 years) |
|
| Previous Employer Phone Number |
|
| Time with Previous Employer |
Years Months |
| |
| Spouse's Information |
| |
| Spouse's Name (First, Middle Initial, Last) |
|
| Spouse's Birth Date |
|
| Spouse's Social Insurance Number
|
|
| Spouse's Employer |
|
| Spouse's Employer Phone Number |
|
| Spouse's Job Title or Occupation |
|
| Spouse's Time with Current Employer |
Years Months |
| Spouse's Monthly Income (Before Taxes and Deductions) |
|
| |
| |
| Additional Information |
| |
| What type of vehicle are you interested in? |
|
| Are you interested in a new or used vehicle? |
New Used |
| If required, do you have a co-signer? |
Yes No |
| If required, do you have a Down Payment? |
Yes No |
| Down Payment Amount: |
|
| Do you have a Trade-In? |
Yes No |
| Trade-In value: |
|
| |
| Privacy Policy |
|
By submitting this application form, you certify that the information you have provided herein is true and correct to the best of your knowledge. You also authorize the Bank/Auto Dealer to conduct a personal investigation, and by submitting this, you accept as notice in writing of and authorize the obtaining of any information required that may be relating to this application, from any source to whom the Bank/Auto Dealer may apply and each source is authorized to provide the financial institution with information. In addition, you authorize the Bank/Auto Dealer to disclose, in response to direct inquiries from any other lender or credit bureau, any information concerning your loan and account that the Bank/Auto Dealer considers appropriate.
|
|
E-mail this to a Friend and earn $100
You can Earn $100 for each person you e-mail this webpage and they purchase a vehicle
This is the message that would be sent to your friends:
(Just put their e-mail below and click "Yes")
|
Do you want to send this e-mail to your friend(s)?
(Just put their e-mail) |
Yes No |
E-mail Friend #1:
|
|
E-mail Friend #2:
|
|
E-mail Friend #3:
|
|
E-mail Friend #4:
|
|
E-mail Friend #5:
|
|
|
WAIT! - If you e-mail this to your friends
be sure to put your name and e-mail above (in the Personal and Residential sections)
or the e-mails won't be sent and you won't be eligible for $100
|
