Fill out the credit application form below, and let the Team at Second Chance Finance begin work on getting the credit you require for the car you need! While we have helped thousands of people to attain financing, if you currently have no job or steady source of income we suggest you address that first before filling in this form!

The more information you provide, the easier it is for us to do our job. Remember, fields in bold and * are required.

Applicant Information
First Name, Middle initial *
Last name *
Date of Birth *
Social Insurance Number *
Planning to purchase a vehicle
Address
City/Town *
Province
Postal Code
Years / Months at current address
Daytime Telephone number *
Evening Telephone number
Cellphone number
Fax
Email Address *
Contact me by
Phone Email Fax

If you have not resided at the above address for at least 2 years, then please enter your previous address below.
Address
City/Town
Province
Applicant Employment Information
Present employer *
Workplace telephone number
Applicant's current occupation
Gross Monthly income(pretax) $ *
How long with present employer?
How long have you been employed in the same line of work?
Department or Supervisor's name
Previous employer *
Applicant's previous occupation
How long with previous employer?
Sources of other income
Other Gross Monthly income(pretax) $
Spousal Information
First Name, Middle initial
Last name
D.O.B. (mm/dd/yyyy)
Social Insurance Number
Daytime Telephone number
Present employer
Workplace telephone number
Spouse's occupation
Gross Monthy income(pretax) $
Homeowner Information
Homeowner status
Own Rent
Mortgage company or Landlord name
Mortgage company or Landlord address
Monthly payment (mortgage/rent) $

If you are renting, please skip to vehicle preference
Original mortgage amount $
Mortgage balance amount $
Current value of home $
Vehicle Preference
Type of vehicle you plan to purchase
Down payment amount on vehicle $
Trade-in year (e.g. 2004)
Trade-in model
Trade-in approximate value $
Vehicle Deposit Information

You only need to fill this section out if your are placing a deposit on a vehicle
Vehicle deposit amount $
Credit Card Type
Credit Card Number
Credit Card expiration date  / 
Bank account type
Chequing Savings Joint
Bank account number
Bank branch address for above account number
Legal Information
APPLICANT AUTHORIZATION:
I hearby authorize Second Chance Finance, a division of AutoWest, Inc.  to conduct a personal credit worthiness 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 AutoWest, Inc. may apply, and each source is authorized to provide AutoWest, Inc. with such information. In addition, I authorize AutoWest, Inc. to disclose, in response to direct inquiries from any other lender or credit bureau, any information concerning my loan and account that AutoWest, Inc. considers appropriate and I agree to indemnify AutoWest, Inc. and save it harmless from any and all claims on damages or otherwise arising from any such disclosure made by AutoWest, Inc.

The applicant is advised that AutoWest, 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 AutoWest, 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.
Please Note:
  • Fields marked in bold with a * are required for serious inquires
  • Credit application requests will be processed the next business day.
  • Please provide information at your discretion.