Loan Application

Unit Information

New or Used?

Neuf

d'occasion

Unit Manufacturer *

Unit Model *

Unit Year *

Unit Sale Price *

$

Unit Sales Tax *

$

Unit Loan Amount *

$

Requested Loan Term *

Has Trade In? *

Yes

No

Unit Used as Dwelling or Residence? (Primary or Otherwise) *

Yes

No

Primary Applicant

First Name *

Last Name *

Phone *

Email *

Date of birth *

Primary SIN *

Annual Income *

$

Martial Status *

Married

Unmarried

Separated

Rent or Own? *

Locataire

Propriétaire

Home Monthly Payment *

$

Time at Address *

Address *

City *

Province *

Province

Alberta
British Columbia
Manitoba
Ontario
Quebec
Saskatchewan
New Brunswick
New Foundland and Labrador
Nova Scotia
Nunavut
Prince Edward Island
Northwest Territories
Yukon
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Postal code *

Drivers License - Front Side

Drivers License - Front Side

Drivers License - Back Side

Drivers License - Back Side

Employment - Primary Applicant

Employment Status *

Employment Status

Employé
Chômeurs
Autonome
Retraité
Autres
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Employer Name

Current Position *

Time at Current Employer *

Current Employer Address *

Current Employer City *

Employer Postal Code *

Employer Province

Current Employer Phone *

Co-Applicant Information

If you have a co-applicant all fields below MUST be submitted.

Relationship to Primary

Co-Applicant SIN

Co-Applicant DOB

Co-Applicant First Name

Co-Applicant Last Name

Co-Applicant Phone

Co-Applicant Email

Co-Applicant Marital Status

Married

Not Married

Separated

Co-Applicant Address

Co-Applicant Employment Status

Employment Status

Employed
Unemployed
Self Employed
Retired
Other
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Co-Applicant Employer

Co-Applicant Time at Employer

Co-Applicant Gross Income

$

FALSIFICATION OF CREDIT INFORMATION TO THE BANK IS A CRIMINAL VIOLATION OF FEDERAL AND ALL STATE LAWS. I/WE UNDERSTAND THAT THE FINANCIAL INSTITUTION TO WHICH THIS APPLICATION IS BEING PRESENTED WILL BE REQUESTED TO EXTEND CREDIT TO ME/US ON THE BASIS OF THIS CREDIT STATEMENT.

Co-Applicant Signature

Clear

Primary Applicant Signature *

Clear

All customer information is kept strictly confidential.