 |
| Name (First, Middle Initial, Last) |
|
| Birth Date |
|
| Social Insurance Number |
|
 |
| Present Address |
|
| City |
|
| Postal Code |
|
| Monthly Rent or Mortgage Payment |
|
| Time at Residence |
Years Months |
| Home Phone Number |
|
| Cellular Phone Number |
|
| Email Address |
|
| Previous Address (if less than 2 years) |
|
| City |
|
| Postal Code |
|
| Time at Residence |
Years Months |
 |
| Employer |
|
| Employer Phone Number |
|
| Job Title or Occupation |
|
| Time with Current Employer |
Years Months |
| Monthly Income (Before Taxes and Deductions) |
|
| Previous Employer (if less than 2 years) |
|
| Previous Employer Phone Number |
|
| Time with Previous Employer |
Years Months |
 |
| What type of vehicle are you interested in? |
|
| Are you interested in a new or used vehicle? |
New Used |
| If required, do you have a co-signer? |
Yes No |
| If required, do you have a downpayment? |
Yes No |
| Downpayment Amount: |
|
| Do you have a trade in? |
Yes No |
| Trade-In value: |
|
 |
|
By submitting this application form, you certify that the information you have provided herein is true and correct to the best of your knowledge. You also authorize the Bank/Auto Dealer to conduct a personal investigation, and by submitting this, you accept as notice in writing of and authorize the obtaining of any information required that may be relating to this application, from any source to whom the Bank/Auto Dealer may apply and each source is authorized to provide the financial institution with information. In addition, you authorize the Bank/Auto Dealer to disclose, in response to direct inquiries from any other lender or credit bureau, any information concerning your loan and account that the Bank/Auto Dealer considers appropriate.
|
|
