Credit Application Form

Applicant Personal Information

Full Name*

Date of Birth*

SIN*

Phone*

Email*

Street*

Apartment/House*

City*

Province*

Postal Code*

Do you Rent or Own your Residence?

Time at Current Residence (years) ?

Previous Residence

City

Province

Postal Code

Co-Signer Information

Full Name

Date of Birth

SIN

Address

Relative Information

Full Name

Relation

Contact Information

Address

General Corporation Information

Legal Business Name*

Contact Information*

Work Phone*

Years in Business* ?

Street Address*

City*

Province*

Postal Code*

% of Ownership*

Type of Business*

CorporationPartnershipProprietorshipOther

Financing and Lending Information

Name of the bank*

Branch*

Phone*

Number of dealings*

Any prior Repossessions* ?

Any legal Suits* ?

Any Bankruptcy*

Personal Net Worth

Assets	Value
Residence*	$
Other Real Estate(s)*	$
Personal Cash/Savings*	$
Personal Vehicle(s)*	$
Investments/RRSP/TFSA/Gold*	$
Total Assets*	$

Liability	Value	Monthly
Mortgage*	$	$
Additional Mortgage/LOC*	$	$
Credit Cards (debts)*	$	$
Leased/Financed Vehicle(s) Auto Loan*	$	$
Total Liabilities*	$	$
Net Worth (Total Assets - Total Liabilities)*	$

Documents required to support this application

Corporation Registration Papers*

Last 3 months bank statements*

T2/Corporation tax return NOA*

Personal tax return NOA*

Driver's Licence*

PR Card / Passport*

Total Driving Experience (years)

Driving History as Company Driver

Current Employer*

Years*

Previous Employer*

Years*

Driving History as Owner Operator

Current Company*

Years*

Previous Company*

Years*

Equipment Information and Proposal

Equipment Cost*

Down Payment*

Term for Lease/finance (years)*

The personal information may be gathered and used by Charger Truck Sales Inc. or its affiliates, its assignees and potential assignees, to provide products and to perform services as may be requested by you. We may also disclose your personal information to third parties such as the manufacturer of your vehicle, credit reporting agencies, financial institutions of financing companies, your insurance agents or company and/or companies which provide or insure warranties relating to your vehicle. You are entitled to access this personal information that you provided and you may ask that it be updated and rectified. I acknowledge that the information, including personal information, may be processed and stored outside of Canada. We may also disclose your personal information where we are permitted by law to do so. By signing this application below, you have consented to these uses and disclosure.

Authorized Signatory*

Date*