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1450 Cedar St
,
Campbell River
,
Campbell River
BC
,
V9W 2W7
Boilerplate
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250-830-4975
Financing
Financing
Source
Vehicle Type
Vehicle VIN
Whats your budget?
*
Under $250/MONTH
$250 - $375/MONTH
$376- $500/MONTH
Over $500 /MONTH
What Is Your Employment Status
*
Employed
Self-Employed
Unemployed
Retired / Pension
Other
Hourly income amount:
*
How many hours per week
*
What is your total monthly pensions?
*
Where Do You Work?
Occupation
*
Employer
*
Employer Phone
*
Years with Employer
*
Months with Employer
*
Do you receive Child Tax?
*
Yes
No
How Much Child Tax Do you get?
*
What is your address?
*
Street Address
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
How Long Have You Been at Your Current Address?
Years at your current address
*
Months at your current address
*
Please Enter Your Previous Address?
*
Street Address
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Do You Rent or Own
*
Rent
Own
Monthly Mortgage or Rent
*
What is your date of birth?
*
Date Format: MM slash DD slash YYYY
What is your Social Insurance Number?
Do You Have Drivers License?
*
Yes
No
What is your Drivers License Number?
Drivers Number
*
Class of License
*
Expiry of License?
*
Date Format: DD slash MM slash YYYY
What Is Your Name?
*
First
Middle
Last
What is Your Phone Number?
*
What is Your Email Address?
*
Do you have a trade-in?
Yes
No
Unsure
Trade In Info
Year
*
Make
*
Model
*
Kilometers
Vin
All Wheel or Front Wheel Drive
AWD
FWD
Leather or Cloth Seats
Leather
Cloth
Sunroof
Yes
No
DVD Player
Yes
No
Navigation
Yes
No
Windshield have chips or a crack
Yes
No
Tires in good condition
Yes
No
Does It have dents or scrapes
Yes
No
Check engine light on
Yes
No
Consent
*
I certify that each of the statements made and answers given in this credit application are true and correct and is made for the purpose of inducing the financing of the purchase of a motor vehicle. I authorize the obtaining of a consumer report to be used in evaluating this application and the obtaining and exchanging of credit information from and with other creditors and consumer reporting agencies.
Phone
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