Apply for Credit as a... Buyer Co-buyer Related Buyer's Information Buyer's Last Name* Buyer's First Name* Relationship to Buyer* Spouse Parent Sibling Other Family Friend Dealership Information Merchant* Sales person* Delivery Date *FOR OFFICE USE ONLY Buyer Information Last Name* First Name* Middle Birth Date* January February March April May June July August September October November December SIN # Gender* Male Female Marital Status Single Married Common-Law Divorced Contact Information Home Phone Cell Phone Email Current Address City Province Postal Code How Long? (years) Months ** If PO Box/ RR address, please provide legal land ** Drivers License # Province Issued Expiry Date **If less then 2 years at current address, please provide previous address.** Previous Address City Province Postal Code How Long? (years) Months ** If PO Box/ RR address, please provide legal land ** Alternate Contact Last Name First Name Phone Number *The individual will not be contacted unless Lender is unable to contact Buyer* Financial Information Name of Bank Account(s): Chequing Savings Credit Card(s): Visa Other MasterCard None Previous Bankruptcy? Yes No Date Discharged: Year Month January February March April May June July August September October November December Housing Information Own Mortgage Holder Market Value $ Mortgage Principal Balance $ Monthly Payment $ Rent Landlord/Rental property name Monthly Payment $ Employment Information Please enter gross income as per last year's personal notice of assessment if self employed Company Position How Long? (years) Months Address City Province Postal Code Phone # Self Employed* Yes No Gross Monthly Income $ ** If employment is less than 2 years, please provide previous employment information. ** Previous Employer Position How Long (years) Months Address City Province Postal Code Phone # Self Employed Yes No Gross Monthly Income $ Authorization The undersigned is applying for credit and verifies that all credit and other information provided to Lifestyles Financial Services Ltd. (LFS) will be true and accurate. LFS and any other bank or finance company involved in this transaction is authorized to conduct a credit investigation on the undersigned and to exchange credit and other information with any credit bureau or reporting agency and any person with whom the undersigned has purposes to have financial dealings. Buyer, please type the date and your name below, then click "I Agree" Date* mm/dd/yy Buyer's Name* Purchase Information Purchase Type* Auto Motorcycle Snowmobile ATV Personal Watercraft Boat Side X Side RV Hot Tub Retail Product Selling Price Condition* New Used Year* Make* Model* Displacement* (CC) MSRP* MFG Warranty* Length* RV Type* Fifth Wheel / Toy Hauler Travel Trailer Tent Trailer Park Model Truck Camper Motorhome - Class A Motorhome - Class B Motorhome - Class C Bus Conversion / Diesel RV Length Trailer Information: Type Year Make Model Boat MotorInformation: Type CC/HP Year Selling Price $ Without Tax: Accessories $ Tire Levy $ Cash Down $ Trade-in $ Lien $ Trade-In Information Trade-In Information Year* MFG* Model* Length RV (m) Additional Notes