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First Name*:
Last Name*:
Title:—Please choose an option—Mr.Mrs.MissMs.
Current Address*:
Postal Code*:
How Long*:
Previous Address (if less than 3 years)*:
Marital Status*:—Please choose an option—SingleMarriedDivorced
SIN*:
DOB*:
Status # (if applicable):
Home #:
Cell #:
Texting*: YESNO
Email*:
Rent or Own*—Please choose an option—RentOwn
Rent/Mortgage Amount (monthly)*:
Mortgage Amount (left owing)*:
Landlord/Mortgage Holder*:
Market Value:
Employer*:
Address*:
Phone #*:
Occupation*:
Gross Monthly Income/Salary*:
Employment Status*: Full TimePart TimeSeasonalRetiredSelf-Employed
Previous Employer (if less than 3 yrs):
Occupation:
How Long:
Address:
Postal Code:
Phone #:
Do you receive any child tax benefit?*YESNO If yes, how much per month do you receive?
Are you currently in a consumer proposal?*YESNO If yes, when is your consumer proposal finished?
Have you had a consumer proposal?*YESNO If yes, when was your last payment made?
Have you claimed bankruptcy in the last 7 years?*YESNO
Are you currently past due on any payments?*YESNO
Do you currently have any open collection items?*YESNO
My signature below indicated that all of the information I have provided is, to the best of my knowledge, truthful. I hereby authorize Fine Ride Auto Sales Ltd. and its credit lenders to obtain, exchange and release my credit reports, personal information, and make any necessary inquires regarding our loan application for the purpose of interested lenders providing funds on our behalf for out conditional vehicle purchase. I authorize those lending institutions that approve this loan application and are willing to provide funds on our behalf to forward a copy of the loan agreement, and all other relevant documents, to Fine Ride Auto Sales Ltd.
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