Financing

Purchaser's Statement

Our friendly, professional staff would be happy to process your application and confirm your financing needs for your vehicle purchase from Auto R Less. **All information is confidential.**

Dealer	Salesman	Date		Time

Purchaser's Name	Birthdate	S.I.N.	Mar. Stat.	Dep.

Spouse's Name	Birthdate	S.I.N.	Mar. Stat.	Dep.

Present Address	City	Prov.	Postal Code	How Long

Previous Addresses in the past 5 years

Present Employer	Position	Phone	Mo. Income	How Long

Previous Employer in the past 5 years



Source of other income

Spouse's Employer

Landlord		Phone	Payments

Mortgage Holder	Value	Balance Owing	Payment

Outstanding Obligations	Original Amt.	Balance Owing	Terms	Purpose



Other Credit References (Within Past 5 Years) - GIVE FULL ADDRESS AND WHEN PAID

Name & address of Present Bank	Account Number		Phone #

Name & Address of Nearest Relative	Relationship		Phone #

Insurance Agent and Address	Insurance Company

APPLICANT'S AUTHORIZATION

I/We warrant & confirm that I/We have no debts other than those listed and that all information given herein is true & complete and I/We understand clearly that is to be used to determine my/our credit responsibility. I/We consent to the obtaining of such information from my/our present or any future employer(s), any credit reporting agency or any other person(s). Autos R Less my require at any time in connection with the credit hereby applied for or any renewal or extension thereof & to the disclosure of any information concerning me/us to any credit reporting agency or to any person(s) with whom I/We have or propose to have financial relations & I/We agree to indemnify you against & save you harmless from any & all claims in damages or otherwise arising from such disclosure on your part and I authorize Autos R Less to conduct a personal investigation of my financial affairs, and I authorize the obtaining of any information required related to this application. In addition, I authorize Autos R Less to disclose any information concerning my loan to other lending institutions or credit bureaus that Autos R Less see fit.

APPLICANT'S SIGNATURE (entering email address signifies a signature)