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Fields marked with * are required
and help us speed your auto loan process.
Thank You
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First Name *
(required) |
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Last Name *
(required) |
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Address *
(required) |
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Your City *
(required) |
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Province *
(required) |
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Postal Code *
(required) |
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How long at this address? *
(required) |
(years/months) |
Date of Birth *
(required) |
(month/date/year) |
Social Insurance Number
(optional) |
(optional speeds approvals) |
E-mail
(optional) |
(optional help us contact you faster) |
Home Phone *
(required) |
(including area code) |
Best
Number to Contact You
Between 9-5? |
(optional help us contact you faster) |
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Owner
Owner with Mortgage
Rent |
| Monthly Payment/Rent |
(if applicable) |
| Do you share the Payment/Rent? |
Yes
No
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| If
Les than 2 years |
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How long at Previous
address?
(years/months) |
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Place of Employment *
(required) |
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| Type of Work |
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How Long have you
been on this Job? *
(required) |
(years/months, do not leave empty put 0 if needed) |
Work Phone
(optional) |
(including area code, optional help us contact
you faster) |
Can
We Contact
You at Work? |
Yes
No
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Gross Income *
(required) |
(before taxes) |
This amount is every, (choose one)
Semi-Monthly (1st and 15th)
Bi-Weekly (every 2 weeks)
Monthly
Yearly |
| Commission |
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| If
Les than 3 years |
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| How
Long with Previous employer |
(years/months, do not leave empty put 0 if needed) |
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Other Source of Income
(specify source) |
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| Amount $ |
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| Describe
the nature of your credit problem? (if
applicable) |
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| How much of a down
payment do you have for buying or leasing a
vehicle? |
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| What is your budget
for a monthly car payment? |
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| If
so Please Describe Your Trade in |
| Trade
in Year |
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| Trade
in Make |
(Ford, Nissan, KIA, GM, Dodge, etc.) |
| Trade
in Model |
(Taurus, Focus, F-150, Neon, Sentra etc.) |
| Trade
in Kilometers |
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Trade in Comments (if
applicable)
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PLEASE
READ
Please be advised you are making
an application for credit. We
do not disclose any non-public
information about you, except
as permitted by law.
By submitting this form, you
certify that all of the statements
in this application are true and
complete and are made for the
purpose of obtaining credit. You
authorize any dealer or lender
who receives this application
to retain it, to rely on it and
to obtain such other information
as it may require, including credit
reports. You also confirm that you have
read the Privacy
Policy and the User
Agreement Sections.
By Submitting
this form, I authorize the
dealers to obtain a credit bureau
on all information provided above.
All false declarations will result
in the automatic refusal of the
credit application. |
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