401Auto Online Credit Application

First Name*

Middle Name

Last Name*

Email Address*

Phone number*

Date of Birth*

Street Name*

Street Number*

Unit Number

Street Type*

City*

Province*

Postal Code*

Years at address?*

Months at address?*

Monthly Payment?*

Rent or Own*

Rent Own

Employer*

Position*

Company Address*

Company Postal Code*

Primary Monthly Income*

Years Employed*

Months Employed*

Secondary Income Source?*

Yes No

Description

Secondary Monthly Income?

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I confirm by submitting this form all statements contained herein are true, and are made for the purpose of obtaining credit. I further acknowledge having read the company’s Privacy Policy Notice, I am a Canadian resident, I have reached the age of majority and I am not applying for the benefit of a third party. I authorize 401 Auto RV Canada Inc. "401 Auto" and their affiliated dealerships to (i) begin a credit application, including permission for 401 Auto to obtain (pull) my consumer credit report; (ii) forward, or allow direct electronic access to my personal information to lenders, financial institutions, or other third parties and to convert and process my personal information as a credit application; (iii) contact me via phone, text, and email. 401 Auto may obtain information about me as described in the Privacy Policy Notice, which 401 Auto handles as stated in the Privacy Policy Notice.