LuxLoans: Start Your Application Now

LuxLoans: Start Your Application Now
Are you 18 years of age or older?*

YesNo
Are you a Canadian Resident?*

YesNo
Have you ever borrowed with us in the past?*

YesNo
Applicant Details
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
How many years have you been staying in this residence?*
Employment Details
Source of Income*

EmployedSelf-EmployedOther
Occupation*
Company Name*
Supervisor's Name*
Work Phone Number*
Payroll Frequency*
Approximate Hire Date*

MonthDayYear
Date
Next Pay Date*

MonthDayYear
Date
Annual Gross Income ($)*
References
Reference 1 Full Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship*
Reference 2 Full Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship*
Loan Details
Requested loan amount?*
Terms and Conditions
I confirm that the information provided in this application is true and accurate.

I authorize LuxLoans to verify my details through Instant Bank Verification (IBV) if required to process my application.

I understand that this information will be kept private and used only to assess my loan eligibility.

By submitting this form, I agree to the terms outlined in the loan agreement if I am approved.
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