Automotive Credit Application
Dealership Information
Dealership Name
Contact Name
Phone Number
( )
Personal Information
Title
First Name
Middle Name
Last Name
Martial Status
Date of Birth
Cell Phone Number
( )
Email
SIN #
- -
Driver's License Number
Learner's License
Current Residence
Address Type
Apartment Number
House No./Box No.
Street Name
City
Province
Postal Code
Home Phone Number
( )
Years at Address
Months at Address
Previous Residence
Address Type
Apartment Number
House No./Box No.
Street Name
City
Province
Postal Code
Home Phone Number
( )
Years at Address
Months at Address
Current Employment
Employment Status
Occupation / Job Title
Employer Name
Employer Phone Number
( )
Employer Address
Employer City
Employer Province
Years with Employer
Months with Employer
Previous Employment
Employment Status
Occupation / Job Title
Employer Name
Employer Phone Number
( )
Employer Address
Employer City
Employer Province
Years with Employer
Months with Employer
Finance Summary
Gross Monthly Salary
Other Monthly Income
Other Monthly Income Description
Total Monthly Income
Current Home Status
Mortgage Holder's Name
Monthly Rent / Mortgage Payment
Home's Market Value
Mortgage Balance
Credit Card Type
Credit Card Number
Other Monthly Obligations
Other Monthly Obligations Description
Banking
Bank Name
Years At Bank
Additional Deal Information
Monthly Payment Range
From $
Up to $
Down Payment
From $
Up to $
Trade In
Co-Applicant
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Vehicle & Deal Notes
Include: Vehicle Information (make, model, trim, kms) and any additional information important to the deal.

I state that all the information above is true and accurate to the best of my knowledge. I authorize Finance West and any affiliated credit agency or financial institution to conduct an investigation into my credit. My submission to this form is an acceptance to authorize the obtaining and release of information as it pertains to processing this application.