Malibu Motors Credit Application

Credit Application Form

Vehicle Information:
Stock Number*	Year Make and Model*	List Price*	Down Payment*

Applicants Information:		* = Indicates required fields
Title*	First Name *	Middle Name	Last Name *

Suffix	Date of Birth*	Social Insurance Number	Language

Marital Status*	No. of Dependents	Drivers License	Email Address

Current Address:
Address Type*	Number*	Apartment Number

Street Name*	Street Type*	Direction

City*	Province*	Postal Code*

Home Phone*	Work Phone	Cell Phone

How long at current address?*
Years: Months:

Previous Address: - IF LESS THAN 2 YEARS
Address Type	Number	Apartment Number

Street Name	Street Type	Direction

City	Province	Postal Code

Home Phone	Work Phone *	Cell Phone

How long at current address?*
Years: Months:

Financial Details:
Gross Monthly Salary $:*
Monthly Commissions $:
Monthly Car Allowance $:
Other Monthly Income $:	Description:	(NOT include Spousal Income)
Total Monthly Income $:
Bank Account Type	Years at Bank

Financial Obligations:
Living Arrangements :		Landlord / Mortgage Holder :

Landlord / Mortgage Holder Address		Original Mortgage Amount

Monthly Payments $:
Market Value $:
Mortgage Balance $:
Other Monthly Obligations:		Description

Current Employment Details:
Employment Type	Occupation
*	*
How long have you been employed in the same line of work?
Years:
Employer	How long have you been with this employer?:
*	Years: Months: *
Address	City

Province	Phone

Previous Employment Details: - IF LESS THAN 2 YEARS
Employment Type	Occupation
*	*
Employer	How long have you been with this employer?:
*	Years: Months: *
Address	City

Province	Phone

Co-Applicants Information:		* = Indicates required fields
Relation to Primary Applicant

Title	First Name *	Middle Name	Last Name *

Suffix	Birth Date*	Social Insurance Number	Language

Marital Status	No. of Dependents	Drivers License	Email: *

Applicant Authorization:

I authorize the Bank to conduct a personal investigation and BY MY SUBMITTING THIS FORM ACCEPT AS NOTICE IN WRITING OF AND AUTHORIZE THE OBTAINING OF ANY INFORMATION REQUIRED RELATED TO THIS APPLICATION from any source to whom the Bank may apply, and each source is authorized to provide the Bank with such information. In addition, I authorize the Bank to disclose, in response to direct inquiries from any other lender or credit bureau, any information concerning my loan and account that the Bank considers appropriate and I agree to indemnify the Bank and save it harmless from any and all claims on damages or otherwise arising from any such disclosure made by the Bank.
The applicant is advised that Malibu Motors. or it's assignee intends to refer to a report from a credit reporting agency in connection with the sale transaction proposed; and the applicant consents to the obtaining of such information from his present and any future employer, any credit reporting agency or any other person Malibu Motors/or its assignee may require at any time in the connection with such transaction and to the disclosure of any information concerning the undersigned to any credit reporting agency or any person with whom the applicant has or proposes to have financial relations.