Credit Application Applicant Information Credit Application Form Step 1 of 4 0% DEALERSHIP NAME*SALESPERSONItem you are purchasing*BOATMOTORIZED RVTRAILERPOWERSPORT (MOTORCYCLE, ATV, SNOWMOBILE)CONDITIONNEWUSEDYEAR*MAKE*MODEL*APPROXIMATE PRICE BEFORE TAXES*DOWN PAYMENT AMOUNT:DO YOU HAVE A TRADE?*YESNO YEAR MAKE MODEL APPROXIMATE VALUE Personal InformationFIRST NAME*MIDDLE NAMELAST NAME*PHONE*CELL PHONEEMAIL DATE OF BIRTH* MM DD YYYY STREET ADDRESS*CITY*PROVINCE*ONABBCMBNBNLNTNSMUPEQCSKYTPOSTAL CODE*DURATION AT CURRENT ADDRESS: YEAR MONTHS By clicking next, you agree that the personal information above may be used and disclosed by DealerPlan and/or it’s agents or service providers (collectively the “Dealer”) as necessary to contact you to verify the above information along with the remaining pages completed. You are also agreeing to allow the Dealer to contact you using the information provided on this form. DRIVER'S LICENSE NO.DRIVER'S LICENSE EXPIRY* MM DD YYYY PROVINCEONABBCMBNBNLNTNSMUPEQCSKYTADDRESS SHOWN ON MY DRIVER'S LICENSE MATCHES MY CURRENT ADDRESSYESNOMARITAL STATUSMARRIEDSINGLEMARRIEDSEPARATEDEMPLOYMENT TYPE*SELF EMPLOYEDEMPLOYEDRETIREDEMPLOYER'S BUSINESS NAMEEMPLOYER'S ADDRESSWORK PHONE NUMBERJOB TITLEDURATION YEAR MONTHS GROSS MONTHLY INCOMEOTHER INCOMESOURCE OF OTHER INCOMEPlease remember in some cases our lenders will ask for proof of income by way of your last pay stub or income tax assessment. Applicant Information (Continued)HOME OWNERYESNOCURRENT MARKET VALUE OF PROPERTY or RENT AMOUNTIS THERE A MORTGAGE?YESNO WHAT COMPANY HOLDS MORTGAGE? MONTHLY PAYMENT APPROXIMATE BALANCE NAME OF YOUR BANK? Once we have an answer for you, we will need to contact you. Please select your preferred method of contact:CONTACT METHOD*HOMEWORKCELLULAREMAILADDITIONAL COMMENTSBy signing below, I consent to the collection, use and disclosure of my personal information as described in this paragraph. I agree that the personal information provided above may be used and disclosed by DealerPlan and/or its agents or service providers (collectively, the "Dealer") as necessary to obtain credit, financial and related personal information (including a credit or consumer information report) about me from any credit bureau or credit reporting agency, and to advise me on credit availability in connection with product and/or service purchase financing. I further agree that the personal information provided above may be disclosed to the provider of Dealer’s website hosting or related services for the purpose of enabling Dealer to access my personal information for marketing purposes. Personal information I provide and credit information obtained may also be retained by Dealer and used to facilitate the application process should I subsequently choose to apply for credit through Dealer. I have read and agree to the Terms & Conditions above.I HAVE READ AND AGREE TO THE TERMS AND CONDITIONS:Date* APPLICANT'S INITIALS* Co-Applicant Personal Information (If Applicable, if not please submit your Application)FIRST NAMEMIDDLE NAMELAST NAMEPHONEEMAIL DATE OF BIRTH MM DD YYYY CommentsThis field is for validation purposes and should be left unchanged.
