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Credit Pre-Approval Form

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

Suffix	Birth Date*	Social Insurance Number*	Language

Marital Status	No. of Dependents	Drivers License*	Email *

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
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 to 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 Obligation:		Description
Credit Card Type:
Credit Card Account Number :

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
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 Landmark Leasing Inc. 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 Landmark Leasing Inc./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.

Note: Credit requests will be processed next business day. Please provide information at your discretion.