Credit Application – Capital Auto

Applicant Information

Name*

*

Date Of Birth*

Social Insurance Number

Primary Phone Number*

Driver's License Number*

Driver's License Province*

Driver's License Expiry Date

Address*

Street Address City State / Province / Region ZIP / Postal Code

Time at Address (years/months)*

Residence Type*

Rent
Own with Mortgage
Own with Free & Clear
Live with Relatives

Monthly Payment*

Mortgage Amount (if owned)

Mortgage Holder (if owned)

Landlord Name (if rented)

Landlord Phone Number (if rented)

Previous Street Address (if less then 2 years at present)

Street Address City State / Province / Region ZIP / Postal Code

Time at previous address (if less than 2 years at current address)

How Would you classify your credit?*

Good
Fair
Poor

Are you currently bankrupt or filling for bankruptcy?*

Yes
No

Marital Status*

E-mail Address*

Applicant Employment Information

Current Employer*

Position*

Phone Number

Time at current employer (years/months)*

Employment Address*

Street Address City Province Postal Code

Employment Type*

Gross Monthly Income (before tax deductions)*

Previous Employer

Previous Employer (If less than 2 years at current)

Position

Phone

Time at previous employer (if less than 2 years at current)

Employment Type (previous)

Gross Monthly Income (previous employer)

Additional Income (Investment income, government subsidies, rental income, baby-bonus, social assistance, etc)

Additional Info (ideal monthly payment, desired vehicle)

*

I hereby certify that the information given above has been completed to the best of my knowledge and is accurate. I fully understand and agree that during the term of my relationship with you, one or more credit bureau checks regarding my financial information and history may be obtained from various credit reporting agencies, and all such information shall be used to determine my credit worthiness. I authorize Capital Auto and any of its affiliates to verify the information provided on this form as to my credit and employment history.

Phone

This field is for validation purposes and should be left unchanged.