CREDIT APPLICATION
PERSONAL INFORMATION
Buyer
SIN
Date of Birth
-
Month
-
Day
Year
Date
Phone
Format: (000) 000-0000.
Marital Status:
Single
Married
Common law
Dependants:
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years/Months
Previous Address (
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years/Months
Email Address
example@example.com
PERSONAL INFORMATION (JOINT APPLICANT)
Buyer
SIN
Date of Birth
-
Month
-
Day
Year
Date
Phone
Format: (000) 000-0000.
Marital Status:
Single
Married
Common law
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years/Months
Previous Address (
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years/Months
EMPLOYMENT & INCOME
Employer
Address/Phone Number
Position
Years/Months
Gross Salary (Monthly)
Other Income (Bonus, Commission)
Benefits:
Benefits checkbox
Yes
No
Previous Employer (< 2 years)
Address/Phone Number
Position
Years/Months
BANKING INFORMATION AND LIABILITIES
Financial Institution
Account Type
Chequing
Savings
Balance:
Housing Status
Own
Rent
Mortgage Payments or Rent - Monthly
Secured?
Secured?
Yes
No
Other Assets, Insurances, Properties, etc.
Purchase Price
Present Value
Balance Owing-Mortgage
Rows
Other Liabilities (CC, Line of Credit, Others)
Limit
Balance
Payments
Secured? Yes No
1
2
3
4
In the last 7 years, have you ever had an asset repossessed or declared bankruptcy?
In the last 7 years, have you ever had an asset repossessed or declared bankruptcy?
Yes
No
In the last 7 years, have you ever been sick or injured preventing you from working?
In the last 7 years, have you ever been sick or injured preventing you from working?
Yes
No
Collateral:
Usage
Personal
Business
Repairs
Personal
Expensed
Estimated Yrs Keeping/KM's
Number of Drivers
Towing Y/N
Usage (circle appropriate)
City
Highway
Gravel
Vacation
CAA Member
Storage
In
Outside
Covered
Lease Customers: Have you decided which option you will be taking advantage of at the end of your agreement?
Keeping
Returning
Not Sure
Signature:
Date:
-
Month
-
Day
Year
Date
I state that all information above is true and accurate to the best of my knowledge. I am authorising this dealer and any affiliated credit agency or financial institution to conduct an investigation into my credit and employment history. My signature is an acceptance in writing to authorize the obtaining and releasing of any relevant and appropriate information required to this application.
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