Secure Finance Application

Statement of Consent

I certify that the information provided by me is correct. I also understand that you will be checking with credit reporting agencies. I authorize an investigation of my credit and employment history and the release of information about my credit experience.

Please initial below to indicate that you have received a copy of our Privacy Notice and agree to all of the above.

YOUR CREDIT APPLICATION IS GOING THROUGH A SECURE WEBSITE AND YOUR IDENTITY IS SAFE

Initial Here

Co-Applicant's Initial Here

Vehicle Information

Type

Condition

Year

Make

Model

Your Contact Information

Name As It Appears on Driver's License

First Name

Middle Name

Last Name

Driver's License #

Driver's License Province

Driver's License Expiration Date

Second ID Type

Second ID Expiration Date

Cell Phone

Residence Phone

E-mail

Social Insurance

Male / Female

Date of Birth

Marital Status

Spouse Name

Spouse Income

Physical Address Information

Physical Address

City

Province

Postal Code

Mailing Address Information

Mailing Address

City

Province

Postal Code

Housing Information

Do you Rent or Own your home, or other?

LandLord / Mortgage Lender

Rent / Mortgage Monthly Amount

Mortgage Balance

Time at Current Residence

Value of House

Previous Residence (If less than 3 years at Current Residence...)

Address

City

Province

Postal Code

How long at Previous Residence

Employer Information

Occupation

Employer

Employer Address

Employer City

Employer Province

Employer Postal Code

Employer Phone

Salary (Annually Gross)

Time at Employer

Type of Employment

Other Income

Other Income Source

Other Income Frequency

Previous Employer Information (If less than 2 years at Current Employer...)

Occupation

Employer

Employer Address

Employer City

Employer Province

Employer Postal Code

Employer Phone

Salary (Annually Gross)

Time at Employer

Additional Comments

Please include any information that you feel may help us process your application.

Joint Applicant Contact Information

First Name

Middle Name

Last Name

Driver's License #

Driver's License Province

Driver's License Expiration Date

Second ID Type

Second ID Expiration Date

Cell Phone

Residence Phone

E-mail

Social Insurance

Date of Birth

Joint Physical Address Information

Physical Address

City

Province

Postal Code

Joint Mailing Address Information

Mailing Address

City

Province

Postal Code

Joint Applicant Housing Information

Do you Rent or Own your home, or other?

LandLord / Mortgage Lender

Rent / Mortgage Monthly Amount

Time at Current Residence

Value of House

Joint Applicant Previous Residence (If less than 3 years at Current Residence...)

Address

City

Province

Postal Code

How long at Previous Residence

Joint Applicant Employer Information

Occupation

Employer

Employer Address

Employer City

Employer Province

Employer Postal Code

Employer Phone

Salary (Annually Gross)

Time at Employer

Other Income

Other Income Source

Other Income Frequency

Joint Previous Employer Information (If less than 2 years at Current Employer...)

Occupation

Employer

Employer Address

Employer City

Employer Province

Employer Postal Code

Employer Phone

Salary (Annually Gross)

Time at Employer

Joint Applicant Additional Comments

Please include any information that you feel may help us process your application.