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Step 1 of 14

7%

What type of vehicle do you want?*
- SUV
- Van
- Car
- Truck

What Is Your Estimated Credit Rating?*
- Good (over 650)
- Fair (550-650)
- Poor (under 550)
- Current Bankruptcy/Proposal
- No credit/unsure

What is your budget?*
- $400-$600/month
- $600-$800/month
- $800-$1000/month
- Over $1000/month

Do you have a trade-in?*
- Yes
- No
- Unsure

What is your employment status?
- Employed
- Self-Employed
- Not working
- Laid off due to COVID-19

Enter your total monthly income*
(before taxes and deductions)

Company Name*
Job Title*

How long have you worked there?*
- 0-3 months
- 3 months - 1 year
- 1-3 years
- 3+ years

What is Your Current Address?

Street Address City Province Postal Code

How long have you lived at your current address?*
- 0-1 Year
- 1-3 Years
- 3-5 Years
- 5+ years

Do you rent or own your home?*
- Rent
- Own
What is your monthly rent payment?
What is your monthly mortgage payment?

What is your date of birth*

What is your name?*
First Last

Email*
Cellphone*
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 a personal investigation to be conducted by the broker and/or lender, 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 authorized to provide the financial institution with information. In addition, you authorize the broker and/or lender to disclose, in response to direct inquiries from any other lender or credit bureau, any information concerning your loan and account that the lender considers appropriate.

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