Secure Finance Application
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Statement of Consent

I certify that the information provided by me is correct. I also understand that you will be checking with credit reporting agencies. I authorize an investigation of my credit and employment history and the release of information about my credit experience.

Please initial below to indicate that you have received a copy of our Privacy Notice and agree to all of the above.

YOUR CREDIT APPLICATION IS GOING THROUGH A SECURE WEBSITE AND YOUR IDENTITY IS SAFE



(Initial here)*

 
 

Vehicle Information

Type*

 

Condition*

 

Year*

 

Make*

 

Brand*

 

Model*

 

Down Payment

 

Your Contact Information

First Name*

 

Last Name*

 

Driver's License

 

Work Phone

 

Residence Phone*

 

E-mail*

 

Social Insurance Number*

 

Marital Status

 

Male/Female

 

Date of Birth*

 

Physical Address Information

Physical Address*

 

City*

 

Province*

 

Postal Code*

 

Housing Information

Do you Rent or Own your home, or other?*

 

LandLord / Mortgage Holder *

 

Rent / Mortgage Monthly Amount*

 

Mortgage Balance *

 

Time at Current Residence*

 

Home Value

Banking Information

Name Of Bank

 

Account Types

 

Name Of Bank

 

Account Types

 

Previous Residence (If less than 2 years at Current Residence...)

Address

 

City

 

Province, Postal Code

 

How long at Previous Residence

 

Employer Information

Occupation*

 

Employer Name*

 

Employer Address*

 

Employer City*

 

Employer Province*

 

Employer Postal Code*

 

Employer Phone*

 

Salary (Annually Gross)*

 

Time at Employer*

 

Type of Employment

 

Other Income

 

Other Income Frequency

 

Additional Comments
Please include any information that you feel may help us process your application

 

Previous Employer Information ( if less than 2 years )

Occupation

 

Employer Name

 

Employer Address

 

Employer City

 

Employer Province

 

Employer Postal Code

 

Employer Phone

 

Salary (Annually Gross)

 

Time at Employer

 

Type of Employment

 

Other Income

 

Other Income Frequency

 

Additional Comments
Please include any information that you feel may help us process your application

 

Upload Signature

Applicant Signature

 

References

Name:

Phone:

City:

Province:

Name:

Phone:

City:

Province:

Name:

Phone:

City:

Province:

Name:

Phone:

City:

Province:

By uploading my digital signature and/or signing this document I/we verify that this information is true to the best of my/our knowledge. By clicking on the 'Submit Credit Application' button below, I/we give permission to Bluenose RV to check my/our credit and provide this information to their lenders to secure financing for my purchase. This information will be utilized only for the purpose for which it is intended, and no access to this information will be given to any employee of Bluenose RV Center not involved in the finance process. Your information will be removed from our secure server within 72 hours.