Credit Application

www.eastgateford.com
Eastgate Ford Credit Application

Please fill out as much information as possible so we may process your application. If any important information is missing, we may contact you to get the missing information.
Fields marked with a * are required and must be filled in.

GENERAL AND CONTACT INFORMATION
First Name	*
Last Name	*
Date of Birth
SIN		Marital Status
Email	*
Home Phone	*
Cell Phone
Work Phone
Best time to call
Have you ever declared bankruptcy?		Yes No
Do you have a co-signer available if needed?		Yes No

RESIDENCE INFORMATION
Address
City		Province
Postal Code		Home Status
Length of Residence		Value of your home
Monthly rent or mortgage payment		Balance of the mortgage
Mortgage Holder/Landlord		Landlords Phone

PREVIOUS ADDRESS
(this section only needs to be filled out if you have been at your current residence less than 3 years)
Address
City		Province
Postal Code		Home Status
Length of Residence

CURRENT EMPLOYMENT
Employment Type
Employment Status
Employer
Occupation
Gross Monthly Income
How long have you been here?

PREVIOUS EMPLOYMENT
Employment Type
Employment Status
Employer
Occupation
Gross Monthly Income
How long did you work there?
Enter Security Code	*
By submitting this application, you authorize Eastgate Ford to make whatever credit inquiries that it deems necessary in connection with this credit application. You authorize and instruct any person or consumer reporting agency to compile and furnish Eastgate Ford with any information that it may have to obtain in response to such information. Eastgate Ford (or whichever of its affiliates may be considering an extension of credit pursuant to your credit application) may share with its affiliates any information it obtains from your credit application or acceptance certificate and any transactions and experiences between you and it. In addition, it may share with its affiliates any other information in relation to you, however, you may request that such information not be shared with affiliates by notifying us in writing to 350 Parkdale Avenue North, Hamilon ON L8H 5Y3 or by calling us at (905) 547-3211.