Terms of Use
Fields marked with * are required and help us speed your auto loan process. Thank You


Secure Server
First Name *
(required)
Last Name *
(required)
Address *
(required)
Your City *
(required)
Province
Manitoba
Postal Code *
(required)
How long at this address?
(required)
(years/months)
Date of Birth *
(required)
(month/date/year)
Social Insurance Number
(optional)
(optional speeds approvals)
E-mail *
(required)
Home Phone *
(required)
(including area code)
Best Number to Contact You
Between 9-5?
(optional help us contact you faster)
Owner Owner with Mortgage Rent
Monthly Payment/Rent
(if applicable)
Do you share the Payment/Rent?
Yes No
If Less than 2 years
How long at Previous address?
(years/months)
Place of Employment
(required)
Type of Work
How Long have you been on this Job?
(required)
(years/months, do not leave empty put 0 if needed)
Work Phone
(optional)
(including area code, optional help us contact you faster)
Can We Contact
You at Work?
Yes No
Gross Income
(required)
(before taxes)
This amount is every, (choose one)
Semi-Monthly (1st and 15th)
Bi-Weekly (every 2 weeks)
Monthly Yearly
Commission
If Less than 3 years
How Long with Previous employer
(years/months, do not leave empty put 0 if needed)
Other Source of Income
(specify source)
Amount $
Describe the nature of your credit problem? (if applicable)
How much of a down payment do you have for buying or leasing a vehicle?
What is your budget for a monthly car payment?
If so Please Describe Your Trade in
Trade in Year
Trade in Make

(Ford, Nissan, KIA, GM, Dodge, etc.)
Trade in Model

(Taurus, Focus, F-150, Neon, Sentra etc.)
Trade in Kilometers
Trade in Comments (if applicable)
PLEASE READ

Please be advised you are making an application for credit. We do not disclose any non-public information about you, except as permitted by law.

By submitting this form, you certify that all of the statements in this application are true and complete and are made for the purpose of obtaining credit. You authorize any dealer or lender who receives this application to retain it, to rely on it and to obtain such other information as it may require, including credit reports. You also confirm that you have read the Privacy Policy and the User Agreement Sections.

By Submitting this form, I authorize the dealers to obtain a credit bureau on all information provided above. All false declarations will result in the automatic refusal of the credit application.
I have read the terms and the above information and i agree
If required, would a consigner be available? Yes No



Privacy | Terms of Use | Dealers Information