Saskatoon RV Superstore - Credit Application

Credit Application


Applicant Name:		BirthDate: (MM/DD/YY)
Number of Dependants:	Applicants Social Insurance:	Applicants Driver's License Number / Province:
Spouse's Name: (include first name and initial)	Spouse's Social Insurance Number:	Spouse's Birth Date: (MM/DD/YY)

ADDRESS INFORMATION

Present Address :

(Street Number and Name)

City:

Province:

Postal Code:

How Long?:
|

(Years | Months)

Home Telephone #:

(include area code)

Email:

Rent Own Room & Board

Rent / Mortgage Amount:

Landlord's Name and Telephone # / Mortgage Holder:

Former Address:

(Street Number and Name) if less than 2 years at present

City:

Province:

EMPLOYMENT INFORMATION

Present Employer Name:

Address:

Business Telephone #:

Nature of Business:

How Long?:
|

(Year | Month)

Occupation:

Gross Monthly Income:

Former Employer Name:

(if less than 2 years at present)

Address:

How Long?:
|
(Year | Month)

Occupation:

Spouse Employer Name:

Address:

Business Telephone #:

How Long?:
|

(Years | Months)

Occupation:

Gross Monthly Income:

Source of Other Income:

Other Monthly Income:

BANK ACCOUNT INFORMATION

Financial Institution:

Address:

Account #:

Balance:

Chequing Savings Other

ASSET AND CREDITOR INFORMATION

Asset Description:

(eg. property, vehicles, investments)

Value:

Creditor Name & Address:

Monthly Payment:

Balance:

Have You Ever Been Bankrupt? Yes No

Have You Ever Had a Repossession? Yes No

PERSONAL REFERENCES

Relationship:

Name, Address & Telephone #:

Employer:

I hereby authorize Saskatoon RV SuperStore to investigate my credit record and to establish and maintain a file of personal information about me. I affirm that all information given above is true and complete. I consent to Saskatoon RV SuperStore obtaining consumer reports and other credit information from, and disclosing consumer reports and other credit information to, credit reporting agencies, the credit bureau, any person or corporation with whom or which I have had financial relations and suppliers of services such as collection agencies or bailiffs and persons which Saskatoon RV SuperStore may have business dealings with specifically related to the servicing and financing of my account. I consent to this collection, use and disclosure of consumer reports and other credit information for the purposes of: assessing my creditworthiness in connection with financing transactions, making a decision about my credit application; monitoring, evaluating, servicing and collecting my account; and responding to inquiries about my application, account or file.