Financing

First Name

Middle Initial

Last Name

Marital Status

Date of Birth

SIN Number

Current Address (Number and Street)

Apt

Phone Number

Email Address

City

Province

Postal Code

How long have you lived at this address?

Rent or Own?

Rent / Mortgage Payment

Employer Name

Position Held

Monthly Gross Income

Have you declared bankruptcy/credit counseling?

Authorization

YES

I/we authorize and consent to AutoBuff and to their lending brokers use of personal and credit information for any reasonable purpose related to the transaction and agree that a personal investigation may be conducted and/or a credit report obtained with respect to the information I/we provide. I/we are aware and consent that this information and any other I/we provide to AutoBuff and its brokers is true and may be shared with third parties in order to arrange financing.