FINANCE

Park Premium Auto and leisure

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.

DATE OF BIRTH *

FIRST AND LAST LEGAL NAME: *

HOW LONG HAVE YOU WORKED AT YOUR CURRENT JOB *

HOW LONG HAVE YOU LIVED AT YOUR CURRENT RESIDENCE *

DO YOU OWN OR RENT YOUR HOME *

HOW MUCH DO YOU PAY FOR YOUR RENT OR MORTGAGE *

CITY AND PROVINCE *

MARTIAL STATUS *

IF LESS THAN 2 YEAR PREVIOUS ADDRESS

COMMENTS AND UNIT YOU ARE INTERESTED IN FINANCING *

CURRENT EMPLOYERS ADDRESS *

PHONE *

ADDRESS *

IF LESS THAN 2 YEARS, WHERE DID YOU WORK BEFORE

POSTAL CODE *

EMPLOYERS PHONE NUMBER *

SOCIAL INSURANCE NUMBER

IF YOU HAVE A MORTGAGE, WHO IS IT WITH? AMOUNT OWING? VALUE OF HOME?

EMAIL: *

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OCCUPATION *

WHAT COMPANY DO YOU WORK FOR *

YEARLY INCOME BEFORE TAXES *

44 SIOUX ROAD, SHERWOOD PARK, ALBERTA (780) 449-1778