==> IMPORTANT! <== PLEASE READ CAREFULLY. Provide information for each field marked with an asterisk (*). Postal codes area Important/ If not applicable, type N/A (for not applicable). ==> IMPORTANT <== When there is a Co-purchaser (cosigner), THE COSIGNER MUST ALSO SUBMIT A SEPARATE APPLICATION. By submitting this form, the applicant provides his/her electronic signature, to authorize Car Store Automotiv Inc. , or its designate, to investigate and to verify applicant credit information. ***We will not share any infomation given to us other than neccesary to provide you credit) ***  Your security is paramount to our organization!

Buyer's Last Name, Initial, and First Name	*
vehicle being considered	*
First and Last Name of Co-purchaser (cosigner)
Buyer Date of Birth	*
Social Insurance Number	*
Indicate Marital Status	*	-- Choose -- Married Divorced Separated Single
Number of dependents	*
Home Phone (XXX-XXX-XXXX format)	*
Work Phone (XXX-XXX-XXXX EXT XXXX)	*
Cell Phone (XXX-XXX-XXXX)	*
Street Address and apt # with postal code	*
Provide name of City, Province, and Postal Code	*
Years and months at above address	*
if address less than 2 years indicate address
Years and months at previous address
Do you Rent or Own?provide details below	*	-- Choose one -- Rent Own
Monthly mortgage payments or rent including taxes
Amount owing on Mortgage
Mortgage company or landlord name with phone number
Your present employer and occupation and address	*
Years and months of employment	*
If employment is less than 2 years/where?gross monthly?	*
Are you self employed?		-- Choose one -- No Yes
Gross Monthly Income	*
Other monthly income	*
Have you claimed Bankruptcy within 7 years?	*	-- Choose one -- No Yes
Please type the Security Code in the box below.	*