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Financial Application Form





Applications Information

Applicants Name: Social Insurance Number:
# of Dependants: Marital Status:
 Single Married Common-Law Divorced
Birth Date: Address:
City: Postal Code:
Home Phone: Work Phone:
Cell Phone: Email:
Previous Address: How Long:
2nd Previous Address: How Long:

Applicant’s Employment Information

Applicants Current Employment: Employer Contact Name & Number:
Self Employed: Position:
How Long: Income: Tax: Additional Income & Source:
Previous Employer: Position: Income: How Long:
2nd Previous Employer: Position: Income: How Long:

Co-Applicant Relationship to Applicant

Applicants Name: Social Insurance Number:
# of Dependants: Marital Status:
 Single Married Common-Law Divorced
Birth Date: Address:
City: Postal Code:
Home Phone: Work Phone:
Cell Phone: Email:
Previous Address: How Long:
2nd Previous Address: How Long:

Co-Applicant’s Relationship Employment Information

Applicants Current Employment: Employer Contact Name & Number:
Self Employed: Position:
How Long: Income: Tax: Additional Income & Source:
Previous Employer: Position: Income: How Long:
2nd Previous Employer: Position: Income: How Long:

Additional Information

Desired Purchase Year: Desired Purchase Make:
Desired Purchase Model: Finance Amount:
Referral Source/Sales Rep: Where did you hear about us?

Trade in Vehicle

Year: Make: Model: Current KM/Hours:

I hereby certify that the information given above is true, accurate and complete as at the statement date. I fully understand that such information shall be used to determine my cedit worthiness. I understand that ALL INFORMATION WILL BE VERIFIED and any information that proves inaccurate may result in the application being terminated. I authorize Silver Comet Auto to obtain all the information it requires. I also authorize Silver Comet Auto to disclose from time to time to other lenders credit bureaus and other reporting agency any credit information about me.

Dated: Signed:
Dated: Signed:

 

 

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