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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
|
| If
Les than 2 years |
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How long at Previous
address?
(years/months) |
|
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Place of Employment
*
(required)
|
|
| 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
|
Gross Income *
(required) |
(before taxes) |
This amount is every, (choose one)
Semi-Monthly (1st and 15th)
Bi-Weekly (every 2 weeks)
Monthly
Yearly |
| Commission |
|
| If
Les than 3 years |
|
| 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 |
|
| Trade
in Make |
(Ford, Nissan, KIA, GM, Dodge, etc.) |
| Trade
in Model |
(Taurus, Focus, F-150, Neon, Sentra etc.) |
| Trade
in Kilometers |
|
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 .
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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