Rick's Deals on Wheels

Confidential Financing Application Form
I. Personal Information
First Name	Middle Name	Last Name
Phone	Email
Date of Birth	SIN	Driver's License
II. Residence Information
Current Address
City	Province	Postal Code
Landlord Name (If Rental)	Landlord Phone	Years at current residence
Previous Address
City	Province	Postal Code
Landlord Name (If Rental)	Landlord Phone	Years at previous residence
III. Employment Information
Current Employer   Position Phone Number Years at current employer Gross Monthly Income Reference Contact
Previous Employer   Position Phone Number Years at previous employer Gross Monthly Income Reference Contact
Additional Source of Income   Gross Montly Income from Additional Sources
IV. Asset(s) Information
Bank Account 1 Bank Name 1 Bank Account 2 Bank Name 2
Investment Totals Description Automobile Year/Make/Model
Real Estate 1 Description of Property Address of Property
Real Estate 2 Description of Property Address of Property
Other Assets Description
V. Debt Information
Monthly Loan Payment Financial Institution Total Owing Type of Loan
Monthly Mortgage Payment Financial Institution Total Owing
Monthly Vehicle Payment Financial Institution Monthly Alimony Payment Other Monthly Payment
Debt Descriptions
By Checking this box I agree that everything stated in this application is true to the best of my knowledge and belief. I consent to conduct a Credit Bureau search in oeder to determine my eligibility for a loan. I accept as notice in writing of and consent to the lender, its assignees or transferees, obtaining or exchanging any information about me at any time from any credit bureau, my employer or any other person.

Rick...he's your friend in the auto sales business This website is hosted by G.Studio.