Personal Credit Application 6921 Steeles Ave. W. Unit #8, Toronto, ON M9W 6T5 Toll Free: 1-855-403-5626 | Tel: (905) 598-5626 | Fax: 1-877-443-6397 Email: credit@cikcapital.com | Web: www.cikcapital.com Applicant 1 FIRST NAME MIDDLE INITIAL LAST NAME SOCIAL INSURANCE NUMBER ADDRESS YEARS THERE CITY PROV POSTAL CODE EMAIL ADDRESS HOME POHNE CELL PHONE BIRTH DATE (MM/DD/YYYY) PREVIOUS ADDRESS YEARS THERE CITY PROV POSTAL CODE REFERENCES (NOT LIVING WITH YOU) 1 PHONE RELATION REFERENCES (NOT LIVING WITH YOU) 2 PHONE RELATION Job Details EMPLOYER (FULL NAME) POSITION BUSINESS PHONE EXTENSION YEARS THERE WORK ADDRESS PREVIOUS EMPLOYER POSITION BUSINESS PHONE EXTENSION YEARS THERE Co-signer Information FIRST NAME MIDDLE INITIAL LAST NAME PHONE RELATIONSHIP TO YOU SOCIAL INSURANCE NUMBER BIRTH DATE (MM/DD/YYYY) ADDRESS YEARS THERE CITY PROV POSTAL CODE DO YOU OWN OR RENT? MORTGAGE AMOUNT (IF OWN) PHONE EMAIL ADDRESS Financial Information and Personal Net Worth Statement YOUR GROSS MONTHLY INCOME (BORROWER 1) $ GROSS MONTHLY INCOME (BORROWER 2) $ ASSETS Cash in Cheqing and Savings DESCRIPTION ESTIMATED MARKET VALUE $ Real Estate Stocks, Bonds, RRSPs, GIC’s Auto (Yr. & Type) TOTAL ASSETS LIABILITIES Loans, Line of Credit, Credit Cards DESCRIPTION AMOUNT Real Estate Mortgage Stocks, Bonds, RRSP, GIC Loan Auto Loan TOTAL LIABILITIES TOTAL NET WORTH (NET WORTH EQUALS TOTAL ASSETS minus TOTAL LIABILITIES) Driving School and Loan Information DRIVING SCHOOL NAME AND ADDRESS DRIVING SCHOOL PHONE AMOUNT TO FINANCE $ FINANCE TERM DRIVING SCHOOL EMAIL ADDRESS Certification and Consent to Collect, Use and Disclose Information I, the Applicant, warrant and confirm that the information given herein is true and correct and I understand that it is being used to determine my credit responsibility. CIK Capital Corp. or its affiliates are authorized to obtain, and any source is authorized to disclose, any information CIK Capital Corp. may require at any time relative to this application from each source to which CIK Capital Corp. may apply and each such source is hereby authorized to provide CIK Capital Corp. with such information. CIK Capital Corp. is furthermore authorized to disclose in response to direct inquiries from lenders or credit bureaus, such information on any loaning account as you consider appropriate and I agree to Indemnify CIK Capital Corp. against and save you harmless from any and all claims in damages or otherwise arising from such disclosure on your part. I specifically acknowledge that CIK Capital Corp. may disclose my personal information regardless of when or how such information was collected, to related companies, financial instruction and credit providers with whom CIK Capital Corp. has financial relations. Upload Files ❌ ❌ APPLICANT 1 SINGATURE APPLICANT 2 SINGATURE DATE 49898
