Canada – Valley Auto Loans

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First Name

Last Name

Birth Date

MM Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YY 199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947

Email Address

Time At Address

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Street Address

City

Province

Please Select AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Postal Code

Home Phone

Work Phone

Residence Type

Please Select Rent Own/Buying Live with Family Other

Housing Payment
(i.e. 0-37,000)

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Employer

Occupation

Employer Phone

Gross Monthly Income

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Employment Type

Please Select W2 Employee 1099/Self Employed Fixed Income

Time Employed

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Down Payment
(i.e. 0-20,000)

Have Checking Account?

Have Savings Account?

When you click the Submit button, you’re (a) telling us that you’re interested in financing the purchase of a motor vehicle, (b) asking us to provide your information to one or more of the organizations with which we do business who might offer you financing or who might be able to identify a source of financing for you, (c) agreeing to receive electronic documents, (d) authorizing us or such those other organizations to receive, review and verify your information, (e) authorizing us or any of those organizations to obtain a credit report about you, and (f) saying that it’s okay to combine your information with other information about you for analysis and marketing purposes, (g) certifying to us and those other organizations that you’re the person whose information you’re submitting, (h) acknowledging that your information will be used for the purposes of obtaining credit, and (i) saying that all of the information that you provide is true and complete. This is not an application for a loan or other form of credit. We don’t make loans or extend credit. We provide your information to organizations with which we do business in the hopes that one or more of them will offer you financing or refer your information on to someone else who will. Although we are usually successful in connecting people with lenders who want to provide auto financing to them, we don’t guaranty that you will receive any offer of financing of that any offer of financing will be on any particular terms. We have no obligation to tell you one way or the other whether we were able to connect you with a potential lender. Each of the authorizations that you give to us also applies to any other organization to which your information is passed. Clicking the Submit button will be your electronic signature. State and federal law makes electronic signatures associated with online agreements like this just as enforceable as agreements on paper that are signed by hand, so don’t click unless you mean it. You are also confirming that you have read and agree to the privacy policy. We look forward to helping you!