Credit Application

Personal Information

Salutation Salutation est

First Name required First Name est required

Middle Name required Middle Name est required

Last Name required Last Name est required

Date Of Birth required Date Of Birth est required

Marital Status required Marital Status est required

Social Insurance Social Insurance est

Gender required Gender est required

Driver's Licence No. Driver's Licence No. est

Expiry Date Expiry Date est

How should we reach you?

Preferred Method of Contact?

Téléphone Texte Courriel Tout

Phone Number required Phone Number est required

Mobile Phone Number Mobile Phone Number est

Work Phone Number Work Phone Number est

E-Mail Address E-Mail Address est

Current Home Address

Address Type required Address Type est required

Street/RR# required Street/RR# est required

Street or Station Name required

Street Type required Street Type est required

Street Direction Street Direction est

Apt/Unit# Apt/Unit# est

Province required Province est required

City/Townrequired City/Town est required

Postal Code required Postal Code est required

Years at Address required Years at Address est required

Months at Address required Months at Address est required

Housing Information

Residential Status required Residential Status est required

Market Value (if owned) Market Value (if owned)Doit être un nombre

Mortgage Balance Mortgage BalanceDoit être un nombre

Monthly Rent/Mort. required Monthly Rent/Mort.requiredDoit être un nombre

Mortgage Co. OR Landlord Name Mortgage Co. OR Landlord Name est

Landlord Phone No. Landlord Phone No. est

Previous Home Address

Previous Address Type Previous Address Type est

Previous Street/RR# Previous Street/RR# est

Previous Street or Station Name Previous Street or Station Name est

Previous Street Type Previous Street Type est

Previous Street Direction Previous Street Direction est

Previous Apt/Unit# Previous Apt/Unit# est

Province

City/Town City/Town est

Previous Postal Code Previous Postal Code est

Years at Previous Address Years at Previous Address est

Months at Previous Address Months at Previous Address est

Current Employment Information

Employment Status required Employment Status est required

Employment Type Employment Type est

Current Employer required Current Employer est required

Years Employed required Years Employed est required

Months Employed required Months Employed est required

Occupation required Occupation est required

Work Contact Phone required Work Contact Phone est required

Work Contact Ext. Work Contact Ext. est

Address Type Address Type est

Street/RR# required Street/RR# est required

Street or Station Name required Street or Station Name est required

Street Type required Street Type est required

Street Direction Street Direction est

Employer Unit# Employer Unit# est

Province required

City/Town required City/Townrequired

Postal Code required Postal Code est required

Current Income Information

Income Amount required Income Amountrequired Must be numeric

Income Frequency required Income Frequency is required

Other Income Amount Other Income Amount Must be numeric

Other Income Frequency Other Income Frequency is

Other Income Type Other Income Type is

Other Income Description Other Income Description is

Previous Employment Information

Previous Emp Status Previous Emp Status est

Previous Emp Type Previous Emp Type est

Previous Employer Previous Employer est

Years Employed required Years Employed est required

Months Employed required Months Employed est required

Previous Occupation required Previous Occupation est required

Previous Work Contact Phone required Previous Work Contact Phone est required

Previous Work Contact Ext. Previous Work Contact Ext. est

Address Type required Address Type est required

Street/RR# required Street/RR# est required

Street or Station Name required Street or Station Name est required

Street Type Street Type est

Street Direction Street Direction est

Employer Unit# Employer Unit# est

Province required

City/Town required City/Town est required

Postal Code required Postal Code est required

Financing Information

Financed Amount Financed AmountDoit être un nombre

Term Term est

Cash Down Cash DownDoit être un nombre

Monthly Payment Monthly PaymentDoit être un nombre

Tell us about your Vehicle

Make Make est

Model Model est

Trim Trim est

Year Year est

Kilometers KilometersDoit être un nombre

VIN VIN est

Colour Colour est

Condition Condition est

Desired Purchase

Asset Type Asset Type est

Asset Classification Asset Classification est

Condition Condition est

Year Year est

Make Make est

Model Model est

VIN / HIN / Serial No VIN / HIN / Serial No

Stock Number Stock Number

Offer OfferDoit être un nombre

Item Request

What type of vehicle are you looking for?

Make Make est

Model Model est

Trim Trim est

Colour Colour est

Year (Min) Year (Min) est

Year (Max) Year (Max) est

Price (Min) Price (Min) est

Price (Max) Price (Max) est

Payment Amount Payment Amount est

Payment Frequency Payment Frequency est

Down Payment Down PaymentDoit être un nombre

Demander un autre véhicule

Service Request

Make Make est

Model Model est

Year Year est

Kilometers Kilometers Must be numeric

Please Select Service Items Required: Oil Change Winter Tires Scheduled Service Diagnose & Repair Detailing

Service Notes Service Notes est

Service Date Requested Service Date Requested est

Service Time Earliest Service Time Earliest est

Service Time Latest Service Time Latest est

How did you hear about us?

Please let us know how you heard about us.

Referral Source Veuillez prendre un moment pour nous dire comment vous avez entendu parler de nous.

Referral Source (Other) Referral Source (Other) est

Customer Comments

Customer Comments est

Disclosure & Privacy Notice

By checking the box below, I consent to the collection, use and disclosure of my personal information as described in this paragraph. I agree that the personal information provided above may be used and disclosed by Grafton Automotive Inc. and/or its agents or service providers (collectively, the "Dealer") as necessary to obtain credit, financial and related personal information (including a credit or consumer information report) about me from any credit bureau or credit reporting agency, and to advise me on credit availability in connection with product and/or service purchase financing. I further agree that the personal information provided above may be disclosed to the provider of Grafton Automotive Inc.'s website hosting or related services for the purpose of enabling Dealer to access my personal information for marketing purposes. Personal information I provide and credit information obtained may also be retained by Dealer and used to facilitate the application process should I subsequently choose to apply for credit through Dealer.

Veuillez confirmer :

I have read and agree to the Terms & Conditions above.

Ajouter un co-demandeur ?

Oui, je souhaite recevoir des offres spéciales et des offres de la part de Grafton Automotive Inc..
Veuillez décocher cette case si vous ne souhaitez plus recevoir d'e-mails de notre part.

Grafton Automotive Inc. s'engage à respecter la vie privée des personnes et reconnaît la nécessité d'une gestion et d'une protection appropriées de toute information personnelle que vous acceptez de nous fournir. Nous ne partagerons pas vos informations avec des tiers en dehors de notre organisation, sauf si cela est nécessaire pour répondre à votre demande.

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