Miedemas Auto Sales


Call: 519-940-3766

Financing

Get Approved For Financing Now! Fill out the application below (This form is secured by SSL for your ssl verificationprotection).

 

    First Name *

    Last Name *

    Home Address *

    City *

    Province *

    Postal Code *

    Home Phone

    Your Email *

    Date of Birth*

    Home Status

    Years at Present Address:

    EMPLOYMENT INFORMATION

    Employer:

    Employer Address:

    Employer Phone:

    Occupation:

    Years Employed:

    Gross Monthly Salary:

    Total Monthly Payments:

    Have you Declared Bankruptcy in the Past 7 Years?
    YesNo

    Is a co-signer available if needed?
    YesNo

    Do you Have a Downpayment?
    YesNo

    S.I.N. Number:

    Drivers License Province of Issue:

    Drivers License Class:

    Drivers License Number:

    Drivers License Expiry

    Notes:

    Describe the type of vehicle you wish to purchase