Road Star Auto Sales Ltd.


CREDIT APPLICATION Privacy Statement: Road Star Auto Sales Ltd. is dedicated to protecting our customers privacy. Any information is on a voluntary basis. Information provided is for internal use only. We do not sell, rent or transmit personal information to other organizations. Please fill in the following areas so we can respond as accurately as possible.
Contact Information
Vehicle of Interest - Year:
Make:
Model:
Your Name:
Street Address:
City:
Province/Territory:
Postal Code:
Telephone:
Fax:
Email address: * Valid email or your request will not be sent.
Date of Birth:
Driver's Licence Number: #
Do you How slong at present address?
Amount of Rent or Mortgage: $
Employment Information
Employment Status:
If employed, please fill out the remainder of this section.
Employer Name:
How Long?
Employer Address:
Occupation:
Work Telephone:
Gross Monthly Income:
Other Monthly Income: $
Financial Information
Financial Institution Name:
Financial Institution Address:
Assets Description Value (ie: RRSP, Investments etc.)
Creditor Name Monthly Payment Balance Outstanding
Our Finance Agent may contact you by phone for additional information.