Contact Information Email * Cell Phone / Primary Phone * Alternate Phone Number of years at address * Monthly rent or mortgage payment * Name and phone number of landlord or mortgage holder If mortgaged, amount of mortgage remaining * If mortgaged, value of property owned * Employment Information Current employer Supervisor's name and phone number Industry or sector Occupation Length of employment Previous employer's information, if current length of employment is less than 2 years Monthly gross income How often are you paid? Wage garnishments - if any, please describe: Other assets
Please list any other major assets you have. For example, for owned vehicles include make, model, year, vin and approximate value.
Asset 1 Asset 1 Value Asset 2 Asset 2 Value Other liabilities
Please list any other major liabilities you have. For example for financed vehicles, include make, model, year, vin and approximate value. For financial liabilities, list the type, institution and value.
Liability 1 Liability 1 Value Liability 2 Liability 2 Value Have you ever been, or are you currently in Bankruptcy? Do you have any outstanding civil court judgements against you? Loan Details Amount requested Down payment Target payment amount Description of desired vehicle including year, make, model, etc. Personal Information Social Insurance Number Marital Status Gender Reference 1 Reference 2 Waiver and conditions I have read and agree to the waiver and conditions below * By checking this box, I hereby acknowledge that B-Pro Auto Credit Ltd. hereinafter identified as the Lender, shall have authority to use, share, and verify, the above information, as they deem necessary, for the purpose of providing the loan requested. The Lender is not obligated to provide the loan requested, as this is an application, not a loan agreement. I agree to pay the costs of borrowing, as set out in the loan agreement that this application may generate. I am not obligated to accept the loan terms until I sign the loan agreement that this application may generate. My signature provides the Lender my consent to contact such parties as listed above, and authorizes the Lender to release such information, financial, personal, or otherwise, as required for the purposes of assessing or verifying my loan eligibility, and the information provided. My signature on this form grants my authorization to any such organizations that the Lender contacts, to provide all information they request, to the Lender. The Lender may use my personal information until such time as my loan, if approved, is repaid in full.