BUYERS ZONE APPLICATION FORM All fields marked are required.

BUYER PERSONAL INFORMATION

Salutation: Dr. Miss Mr. Mrs. Ms. Prof. Gender: Female Male S.S.N: * First Name: * Marital Status: Common Law Divorced Married Separated Single Widowed Phone: * Middle Name: Date of Birth: * Email: * Last Name: * Relation: CommonLaw Employer Friend In-Law Parent Sibling Spouse

Co-BUYER PERSONAL INFORMATION

Salutation: Dr. Miss Mr. Mrs. Ms. Prof. Gender: Female Male S.S.N: * First Name: * Marital Status: Common Law Divorced Married Separated Single Widowed Phone: * Middle Name: Date of Birth: * Email: * Last Name: * Relation: CommonLaw Employer Friend In-Law Parent Sibling Spouse

BUYER CURRENT ADDRESS

Address Type: Postal Box Rural Route Street Direction1: * City: * Suite No. Direction2: Postal Code: State: Select your State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming * Duration: Yr(s). * Mth(s).

BUYER CURRENT EMPLOYMENT

Type: At home Executive Labourer Management Office Staff Other Production Professional Retired Sales Self-Employed Semi Professional Service Student Trades Unemployed State: Select your State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Telephone: * Employer: City: * Extension: Status: Contract Full time Full time on probation On Strike Other Part time casual Part time regular Retired Seasonal Temporary Temporary Layoff     Postal Code: Occupation: Duration: Yr(s). * Mth(s). Address:

HOME / MORTGAGE DETAILS

Home: Other Own Parent Rent Mortgage Amount: * Monthly Payment: * Market Value: Mortgage Holder: *

INCOME DETAILS

Gross Income: * per Year Total Other Assets: Total Other Liabilities:

ADDITIONAL INFORMATION

Desired Purchase: Referral Source / Sales Rep: Where did you hear about us? 1. Auto Trader 2. Family/Friend 3. Internet 4. Newspaper/Flyer 5. Radio 6. Television 7. Other Comments / Feedback:

Trade in

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