What is your monthly budget for a car payment?

$200$300$400+$500

What is your credit rating?

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What is your Gross Monthly income(before taxes)?

Contact Information

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Salutation (required)
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First Name (required)
MIddle Name (required)
Last Name (required)
Date of Birth
Social Insurance Number (required)
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Current Home Address (required)
City (required)
Province Postal Code Years at Address (required)

What is your home status? RentOwn w/MortgageOwnLive with ParentsNo Rent
What is your monthly payment?

Employment Information

Employer Job Title
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Province Postal Code Years Employed (required)

Financial Information

Who do you currently bank with?
Have you declared bankruptcy the past 7 years? YesNo
Do you current have any established credit cards? 0123+4

Disclosure & Privacy Notice

By checking this box, 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 Access Auto Sales Ltd. 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 Dealer’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.
I have read and agree to the Terms & Conditions above.

What Vehicle are you applying for?

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