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Credit Application

Salutation

First Name

Middle Initial

Last Name

Social Insurance No.

Home Phone

Mobile Phone

Marital Status

Birth Date

Address Information

Postal Code

Street Address

City

Province

Duration: Years Months

Previous Address

Street Address

City

Province

Postal Code

Duration: Years Months

Home/Mortgage Details

Rent or Own

Rent

Monthly Rent Payment

Mortgage

Monthly Mortgage Payment

Name of Mortgage Holder

Home Market Value

Remaining Mortgage Amount

Current Employment

Employment Type

Title

Current Employer

Phone

Employer Address

City

Province

Duration: Years Months

Other Income (include description and/or employer name and monthly income)

Previous Employment

Previous Employer

Duration: Years Months

Income Details

Gross Income (before taxes)

Estimated Credit Rating

Previous bankruptcy or consumer proposal?

Are you a Co-Signer?

Cosigner Information

If so, who are you cosigning for?

Other Details

Have trade-in vehicle?

Year

Make

Model

Mileage (in KM)

Desired Value

Desired Make

Vehicle type

Specific type

Desired Down Payment

Desired Monthly Payment

Time frame to see vehicle?

Additional Comments

I certify that each of the statements made and answers given in this credit application are true and correct and is made for the purpose of inducing the financing of the purchase of a motor vehicle. I authorize the obtaining of a consumer report to be used in evaluating this application and the obtaining and exchanging of credit information from and with other creditors and consumer reporting agencies.

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