1239 Plains Road East
Burlington On
905-639-2306
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Online Credit Application

Speed up your purchase or your lease by making an on-line credit check!

This is not an official document. We will contact you as soon as the process is completed.


I plan to buy (or lease) a vehicle in:
Amount of deposit:
Monthly payment required:


Personal Information
Name:
Date of birth (year/month/day):
E-mail:
Phone (with area code): -
Fax (with area code): -
Address:
City:
Province:
Postal Code:
At this address since: years

OWNER  (if applicable)
Mortgage Institution:
Phone (with area code): -
Account number:


TENANT  (if applicable)
Name of landlord:
Phone (with area code): -
Monthly Rent $:



OTHER  (if applicable)

Specify:
Balance $:
House Value $:


Present Employer
Company or Owner:
How long (years,months):
Position:
Phone at work: -
Income $: (per annum)


Previous Employer
Company or Owner:
How long (years,months):
Position:
Phone at work: -

2nd Previous Employer
Company or Owner:
How long (years,months):
Position:
Phone at work: -


Other Source of Income
Specify:
Amount $:


Assets, Other than above (Ex. RRSP's, Investments etc.)
Specify:
Nature:
Value $:


Bank Account Information
Bank Name:
Address:
Phone (with area code): -
Have you ever been bankrupt? No    Yes
Do you have a credit card? No    Yes
If yes, specify the type: Visa    Mastercard    Amex    Other


Other Bank Account Information
Bank Name:
Address:
Phone (with area code): -


By submitting our credit application form you have authorized Bretton's to obtain a credit
check on all information provided above.

        
 
   

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