Application

North Shore Car Company Finance Application

Personal Information

Name:

Email Address:

Home Phone:

Cell Phone:

Date of Birth:

SIN:

Drivers License No:

Marital Status:

Dependants:

Present Address

Street:

City:

Province:

Postal Code:

Resident Status:

Length At Residence:

If Less Than 2 years - Previous Address

Previous Street:

Previous City:

Previous Province:

Previous Postal Code:

Length At Previous Residence:

Financial

Rent / Mortgage Amount:

Balance of Mortgage:

Value of House:

Landlord / Mortgage Holder:

Credit Card Type:

Credit Card Number:

Yearly Wages Income:

Yearly Other Income:

Other Income Source:

Have You Declared Bankruptcy:

Bankruptcy Date:

Present Employment

Employed:

Length Of Employment:

Employer:

Occupation:

Employer Address:

Employer Phone:

If Less Than 2 Years Previous Employment

Previous Employer:

Previous Employer Phone:

Previous Employer Address:

Previous Occupation:

Previous Length Of Employment:

Vehicle

Type Of Vehicle:

Year Of Vehicle:

STK#:

Make Of Vehicle:

Model Of Vehicle:

Amount Of Vehicle: (Before Taxes)

Down Payment: