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Good Credit? Bad Credit? No Credit? FREE Delivery BC and Alberta Best Rates! 0 down Plans Available 1-888-635-9911 Credit Application Tell us about yourself... First Name: Initial: Last Name: Birthdate: (month/day/year) SELECT January February March April May June July August September October November December   SELECT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   SELECT 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 SIN: Email: Home/Main Phone: Cell Phone: Tell us about where you live... Address: City: Province: Alberta BC Manitoba New Brunswick Newfoundland Nova Scotia NWT Nunavut Ontario PEI Quebec Saskatchewan Yukon Postal Code: How long at this address: yrs If less than 2 years please enter previous address below Rent or Own?: Own Rent Rent per month: Landlord or Mortgage Holder Name and Phone Number: Previous Address: City: Province: Alberta BC Manitoba New Brunswick Newfoundland Nova Scotia NWT Nunavut Ontario PEI Quebec Saskatchewan Yukon Postal Code: How long at this address: yrs Rent or Own?: Own Rent Rent per month: Tell us about where you work... Occupation: Monthly Income: Employer: Work Phone: Location: How Long: yrs If less than 2 years please enter previous employer below Previous Employer: How Long: What kind of vehicle would you like... Type: No Preference Car Truck Mini Van SUV Luxury Hybrid Make/Model: Engine Size: Exterior Color: Interior Color: Additional Vehicle Information: Tell us your finance preferences... Do you presently:   Own a vehicle Lease a vehicle Existing auto loan Do not own a vehicle Do you have a trade-in vehicle: Do you have a down payment: Contact me by:   Email Cell Phone Home/Main Phone Work Phone Additional Comments: How did you find us:   Newspaper Radio/TV Referral Other Please prove you're human, by answering this security question... What is 7 + 8: I hereby authorize AutoCredit911.com and any of it's agents, representatives and/or partners to collect, use and disclose any of my personal information for the purposes of investigating and providing financial services. I acknowledge that my personal information may/will be: collected, used and disclosed for the following purposes: (1) to collect credit and related financial information for me, from credit agencies, and from any parties as required, as well as the verification of my employment as stated. (2) to use the information collected to determine my financial situation, to provide financial services I have requested and to offer products and services of AutoCredit911.com and any of it’s agents, representatives and/or partners that may be of benefit to me. (3) to share the information with assignees, bankers or funding partners of AutoCredit911.com (4) to share the information collected and any information on my financial dealings with AutoCredit911.com with credit agencies or other financial institutions. Further, I specifically acknowledge that AutoCredit911.com may assign this agreement and any related agreements in whole or in part from time to time and I agree that any personal information collected in relation to this agreement may be made available to any such purposed assignee. For any inquiries regarding the privacy policies of AutoCredit911.com please contact us at 1-888-635-9911. If you are not completely comfortable filling out our on-line form, please feel free to print out a copy and fax it to 604-795-9618. AutoCredit911_Credit_Application.pdf

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