FINANCE APPLICATION Please enable JavaScript in your browser to complete this form.Name *FirstLastPhone *Alternative PhoneCanadian Status *Canadian CitizenPermanent ResidentTemporary Resident/Work PermitTemporary Resident/Student PermitRefugee ClaimantSIN #Gender *FemaleMaleMarital Status *SingleMarriedCommon LawWidowedDivorcedDate of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920EmailAddress *Address Line 1Address Line 2CityState / Province / RegionPostal CodeTime living at this address *Years/MonthsHome Status *RentOwnLiving with parentsMonthly Payment/Rent *Home Market ValueMortgage AmountPrevious AddressTime living at this addressEmployment InformationCompany Name *Company AddressCompany Phone Number *Position HeldType of EmploymentFull timePart timeSelf-employedRetiredLength of EmploymentGross Monthly Income (before taxes)Is length of current employment greater that 2 years? *YesNoIf your started your current job less that 2 years ago, please fill up the information for your previous employment.Company Name *Company Address Company Phone Number *Position Held Type of EmploymentFull timePart timeSelf-employedRetiredLength of Employment Gross Monthly Income (before taxes) Other Income Source and Amount Co-signer available? *YesNoCo-signer InformationName *FirstLastDate of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Canadian Status *Canadian CitizenPermanent ResidentTemporary Resident/Work PermitTemporary Resident/Student PermitRefugee ClaimantSIN #Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodePhone Number *Co-signer Employment InformationCompany Name *Company AddressPhone *Position HeldType of EmploymentFull TimePart TimeSelf-employedRetiredLength of Employment (months/years)Monthly Gross Income (before taxes)Did you ever declare Bankruptcy? *YesNoHave you been discharged?YesNoDate DischargedMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Have you visit the dealership?YesNoIf yes, did you leave a deposit?YesNoVehicle InformationIf you selected a vehicle from the inventory please fill up the Year/Make/ModelHow do you rate your credit?ExcellentAverageBadUpload the Retail Bill of Sale or any other document related to the application Click or drag a file to this area to upload. Other Information (comments and question, etc.)Terms and ConditionsPlease read the following I certify that all of the information provided by me in any credit application or other documentation given in connection with a Transaction is true, accurate, and complete in all respects. I authorize and consent to the use by Ontario Underwriters/Sam's Auto/Maximum Motor Car or their affiliates initiating, processing, or executing any transaction requested by me, and all reasonable purposes related thereto, including: a) For legal, regulatory, audit, risk assessment, processing, and security purposes (including fraud prevention); b) For purposes permitted by Canadian law or required by Canadian or applicable foreign law. c) To create aggregated and anonymous information that may be used for your business purposes; d) To conduct credit and insurance investigations concerning me from time to time in connection with a Transaction; e) To exchange my Personal information with any credit reporting agency, credit bureau, automobile or other asset insurer or aggregator of information for such insurer and/or financier in connection with considering or proceeding with a Transaction.I have read the information and hereby agree to all terms and conditions. *AgreeSubmit