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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 |
| Mortgage Holder/Landlord Name |
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| Market Value |
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| Bank Name |
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| Monthly Payment/Rent |
(if applicable) |
| Do you share the Payment/Rent? |
Yes
No
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| If
less than 3 years |
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How long at Previous
address?
(years/months) |
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Previous Address *
(required) |
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City *
(required) |
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Province *
(required) |
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Postal Code *
(required) |
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| Are you self-employed? |
Yes
No
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Place of Employment *
(required) |
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| Employer's Address |
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| Address |
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| City |
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| Postal Code |
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| Province |
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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
Less than 3 years at Current Employer |
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| How
Long with Previous employer |
(years/months, do not leave empty put 0 if needed) |
| Previous Employer's Address |
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| Address |
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| City |
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| Province |
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| Postal Code |
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| Phone |
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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 payment budget? |
Bi-Weekly |
Monthly |
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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 Section.
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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