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Dealer Application / Private Sale / Pre-Approval
Dealership Name (Enter "Private Sale" if not purchasing at dealership)
Contact Name
Phone Number
( )
Personal Information
Title
First Name
Middle Name
Last Name
Marital 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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Product & Deal Notes
Include: Product Information (year, make, model, trim, sale price, kms if applicable). Add any additional information important to the deal.

I/We certify all the information in this application is true and complete. I/We acknowledge the personal information gathered may be used by Rossi Financial Inc, FastRVFinancing, its funders, agents and assigns, to assess my credit worthiness, provide products, administer the contract and perform services as requested by me. Rossi Financial may disclose this information to third parties such as but not limited to credit reporting agencies, financial institutions, finance companies, and my insurance agent or company. Rossi Financial may also disclose this information where required bylaw. You can withdraw this consent at any time by contacting Rossi Financial and understand this may be cause for declining your credit application. By signing below, I/We consent to these uses and disclosures and my submission is an acceptance to authorize the obtaining and release of information as it pertains to processing this credit application.

Providing a Social Insurance Number("SIN") is not mandatory. If we are unable to confirm your identity for the purpose of assessing your creditworthiness, we may request it. If declined, this may be cause for declining your Credit Application.

You certify you have requested all correspondence and Loan documentation in English.

PLEASE ENSURE THERE ARE NO YELLOW FIELDS ABOVE BEFORE PRESSING SUBMIT BUTTON
If so, clear out that field and retype the information.