Credit Application

Full Name:
First: Middle: Last:
required required
Present Address:
Street Address:
required
City:
required
Province: Postal Code:
select an item required
   
How Long? Years Months
Previous Address (if less than 3 years at present):
Street Address:
City:
Province: Postal Code:
   
How Long? Years Months
Telephone Number :
Home Phone Number: Work Phone Number:
Date of Birth:
Day: Month: Year:
(YYYY)
Family Status :
Single Married Divorced Separated
 
Number of Dependants:
Employment Information:
Please Indicate Your Employment Status:
 
Employed Full-Time Employed Part-Time Work Casually Self Employed
 
Business/Employer Name:
Job Title/Position :
Street Address:
City:
Province: Postal Code:
   
How Long? Years Months
Previous Employment Information (if less than 3 years at present):
Business/Employer Name:
Job Title/Position :
Street Address:
City:
Province: Postal Code:
   
How Long? Years Months
Annual Income:
Salary: Commission: Car Allowance: Total: Other Income:
Details:
Bank Information:
Bank Name: Address: Phone Number : Account #: How Long?
Landlord or Morgage Holder:
Do you Own or Rent your Home? Own Rent
 
Please Provide the Name and Address of your Landlord or Mortgage Holder:
 
Name: Address:
   
If You Rent Your Home, Please Provide the Monthly Payment or Rent Amount:
 
If You Own Your Home, Please Provide the Mortgage Amount:
and Include the Market Value of Your Home:
Please Provide a Description of What you are Looking for:
 


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©2007 Advantage Auto & Trailer Sales, 770 Highland Avenue, Brandon, Manitoba, R7C 1A7.
Phone: 204-729-8989. Toll Free 1-888-571-8899