Auto Equity Loan Application

Servicing: Calgary, Edmonton, Red Deer, Lethbridge, Medicine Hat, all Alberta*
*some restrictions apply

Rossi Financial Auto Equity Loan Application

Full Name *

First

Last

All fields with an asterisk * are mandatory

Date of Birth: *

Driver's license number:

Email *

Phone

Home Address: (As per drivers licence.)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Time at current address: *

Is the vehicle jointly owned? *

VEHICLE INFORMATION

Year: *

Make: *

Model: *

Trim:

Vin # *

KMS: *

Free & clear ownership? *

If "No" Amount Owed:

Vehicle Registration Status: *

Active
Rebuilt

Additional Information: (damage / required repairs)

Amount of equity you are looking to borrow? *

Credit Check Options: *

NO CREDIT CHECK - The application information I am providing will not be used to asses my credit worthiness. I understand this does not make me eligible for a reduced interest rate and the rate will be 25.00% - 29.99%.
CREDIT CHECK - I understand the credit information I am providing will be used to asses my credit worthiness for this loan. I also understand I am applying for the lower interest rate program which, upon review of my credit, I may or may not qualify for. Subject to the amount borrowed and my credit score I understand rates vary between 14.95% - 29.99%.

Disclosure Statement:

I/We certify all the information in this application is true and complete. I/We acknowledge the personal information gathered may be used by Rossi Financial Inc. to assess the eligibility of my vehicle for the program. If the Credit Check option is selected the information will be used to assess my credit worthiness, administer the contract and perform services as requested by me. Rossi Financial may disclose this information to third parties such as but not limited to credit reporting agencies, financial institutions, finance companies, and my insurance agent or company. Rossi Financial may also disclose this information where required bylaw. By signing below, I/We consent to these uses and disclosures and my submission is an acceptance to authorize the obtaining and release of information as it pertains to processing the application.

You certify you have requested all correspondence and Loan documentation in English.

Signature *

Clear Signature

Today's Date: *

For faster funding upload photos (4 Exterior sides, VIN number, Odometer, Interior)

Click or drag a file to this area to upload.