Credit Application

Personal Information
Salutation is
First Name is required
Middle Name is required
Last Name is required
Date Of Birth is required
Marital Status is required
Social Insurance is
Gender is required
Driver's Licence No. is
Expiry Date is
How should we reach you?
Preferred Method of Contact?

Phone Number is required
Mobile Phone Number is
Work Phone Number is
E-Mail Address is
Current Home Address
Address Type is required
Street/RR# is required
Street Type is required
Street Direction is
Apt/Unit# is
Province is required
City/Town is required
Postal Code is required
Years at Address is required
Months at Address is required
Housing Information
Residential Status is required
$
Market Value (if owned)Must be numeric
$
Mortgage BalanceMust be numeric
$
Monthly Rent/Mort.requiredMust be numeric
Mortgage Co. OR Landlord Name is
Landlord Phone No. is
Previous Home Address
Previous Address Type is
Previous Street/RR# is
Previous Street or Station Name is
Previous Street Type is
Previous Street Direction is
Previous Apt/Unit# is
City/Town is
Previous Postal Code is
Years at Previous Address is
Months at Previous Address is
Current Employment Information
Employment Status is required
Employment Type is
Current Employer is required
Years Employed is required
Months Employed is required
Occupation is required
Work Contact Phone is required
Work Contact Ext. is
Address Type is
Street/RR# is required
Street or Station Name is required
Street Type is required
Street Direction is
Employer Unit# is
Postal Code is required
Current Income Information
$
Income Amountrequired Must be numeric
Income Frequency is required
$
Other Income Amount Must be numeric
Other Income Frequency is
Other Income Type is
Other Income Description is
Previous Employment Information
Previous Emp Status is
Previous Emp Type is
Previous Employer is
Years Employed is required
Months Employed is required
Previous Occupation is required
Previous Work Contact Phone is required
Previous Work Contact Ext. is required
Address Type is required
Street/RR# is required
Street or Station Name is required
Street Type is
Street Direction is
Employer Unit# is
City/Town is required
Postal Code is required
Financing Information
$
Financed AmountMust be numeric
Term is
$
Cash DownMust be numeric
$
Monthly PaymentMust be numeric
Tell us about your Vehicle
I have a vehicle to Trade-In 
Make is
Model is
Trim is
Year is
KilometersMust be numeric
VIN is
Colour is
Condition is

×
Desired Purchase
Asset Type is
Asset Classification is
Condition is
Year is
Make is
Model is
VIN / HIN / Serial No
Stock Number
$
OfferMust be numeric
Item Request
What type of vehicle are you looking for?
Make is
Model is
Trim is
Colour is
Year (Min) is
Year (Max) is
Price (Min) is
Price (Max) is
Payment Amount is
Payment Frequency is
$
Down PaymentMust be numeric
Request Another Vehicle
Service Request
Make is
Model is
Year is
Kilometers Must be numeric
                   
Service Notes is
Service Date Requested is
Service Time Earliest is
Service Time Latest is
How did you hear about us?
Please let us know how you heard about us.
Please take a moment to tell us how you heard about us.
Referral Source (Other) is
Customer Comments
Customer Comments is
Disclosure & Privacy Notice

By checking the box below, I consent to the collection, use and disclosure of my personal information as described in this paragraph. I agree that the personal information provided above may be used and disclosed by Grafton Automotive Inc. and/or its agents or service providers (collectively, the "Dealer") as necessary to obtain credit, financial and related personal information (including a credit or consumer information report) about me from any credit bureau or credit reporting agency, and to advise me on credit availability in connection with product and/or service purchase financing. I further agree that the personal information provided above may be disclosed to the provider of Grafton Automotive Inc.'s website hosting or related services for the purpose of enabling Dealer to access my personal information for marketing purposes. Personal information I provide and credit information obtained may also be retained by Dealer and used to facilitate the application process should I subsequently choose to apply for credit through Dealer.


I have read and agree to the Terms & Conditions above.


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Grafton Automotive Inc. is committed to respecting the privacy of individuals and recognizes a need for the appropriate management and protection of any personal information that you agree to provide us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request.