Consumer Credit Application 1Personal Information2The Application Personal InformationName* First Middle Last Address* Street Address City*Province*AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal Code*Email Telephone*CellularRequest a callback Cancel application and speak with one of our representatives instead. By checking this box you will skip the online application. A representative will contact you instead. Years at current residence:*Select0 Years0.5 Years1.0 Years1.5 Years2.0 Years2.5 Years3.0 Years3.5 Years4.0 Years4.5 Years5.0 Years5.5 Years6.0 Years6.5 Years7.0 Years7.5 Years8.0 Years8.5 Years9.0 Years9.5 Years10.0 Years10.5 Years11.0 Years11.5 Years12.0 Years12.5 Years13.0 Years13.5 Years14.0 Years14.5 Years15.0 Years15.5 Years16.0 Years16.5 Years17.0 Years17.5 Years18.0 Years18.5 Years19.0 Years19.5 Years20.0 Years20.5 Years21.0 Years21.5 Years22.0 Years22.5 Years23.0 Years23.5 Years24.0 Years24.5 Years25.0 Years25.5 Years26.0 Years26.5 Years27.0 Years27.5 Years28.0 Years28.5 Years29.0 Years29.5 Years30.0 Years30.5 Years31.0 Years31.5 Years32.0 Years32.5 Years33.0 Years33.5 Years34.0 Years34.5 Years35.0 Years35.5 Years36.0 Years36.5 Years37.0 Years37.5 Years38.0 Years38.5 Years39.0 Years39.5 Years40.0 Years40.5 Years41.0 Years41.5 Years42.0 Years42.5 Years43.0 Years43.5 Years44.0 Years44.5 Years45.0 Years45.5 Years46.0 Years46.5 Years47.0 Years47.5 Years48.0 Years48.5 Years49.0 Years49.5 Years50.0 YearsPrevious Address InformationIf less than 2 years at current residence please fill out previous address information. Previous Address*Since*(indicate the year eg) 1983)Social Insurance NumberDate of Birth* MM slash DD slash YYYY Marital Status Single Common Law Married Widowed Divorced Number of DependantsReal Estate* Homeowner Renter Monthly Mortgage/Rent Payment ($)*Value of Real Estate ($)Mortgage Balance ($)Previous Bankruptcy Y/N?NoYesEmploymentCompany*Type of Business*Position*AddressLength of Employment*Select0 Years0.5 Years1.0 Years1.5 Years2.0 Years2.5 Years3.0 Years3.5 Years4.0 Years4.5 Years5.0 Years5.5 Years6.0 Years6.5 Years7.0 Years7.5 Years8.0 Years8.5 Years9.0 Years9.5 Years10.0 Years10.5 Years11.0 Years11.5 Years12.0 Years12.5 Years13.0 Years13.5 Years14.0 Years14.5 Years15.0 Years15.5 Years16.0 Years16.5 Years17.0 Years17.5 Years18.0 Years18.5 Years19.0 Years19.5 Years20.0 Years20.5 Years21.0 Years21.5 Years22.0 Years22.5 Years23.0 Years23.5 Years24.0 Years24.5 Years25.0 Years25.5 Years26.0 Years26.5 Years27.0 Years27.5 Years28.0 Years28.5 Years29.0 Years29.5 Years30.0 Years30.5 Years31.0 Years31.5 Years32.0 Years32.5 Years33.0 Years33.5 Years34.0 Years34.5 Years35.0 Years35.5 Years36.0 Years36.5 Years37.0 Years37.5 Years38.0 Years38.5 Years39.0 Years39.5 Years40.0 Years40.5 Years41.0 Years41.5 Years42.0 Years42.5 Years43.0 Years43.5 Years44.0 Years44.5 Years45.0 Years45.5 Years46.0 Years46.5 Years47.0 Years47.5 Years48.0 Years48.5 Years49.0 Years49.5 Years50.0 YearsGross Monthly Salary ($) I have a secondary income Secondary IncomeCompany*Type of Business*Position*AddressLength of Employment*Select0 Years0.5 Years1.0 Years1.5 Years2.0 Years2.5 Years3.0 Years3.5 Years4.0 Years4.5 Years5.0 Years5.5 Years6.0 Years6.5 Years7.0 Years7.5 Years8.0 Years8.5 Years9.0 Years9.5 Years10.0 Years10.5 Years11.0 Years11.5 Years12.0 Years12.5 Years13.0 Years13.5 Years14.0 Years14.5 Years15.0 Years15.5 Years16.0 Years16.5 Years17.0 Years17.5 Years18.0 Years18.5 Years19.0 Years19.5 Years20.0 Years20.5 Years21.0 Years21.5 Years22.0 Years22.5 Years23.0 Years23.5 Years24.0 Years24.5 Years25.0 Years25.5 Years26.0 Years26.5 Years27.0 Years27.5 Years28.0 Years28.5 Years29.0 Years29.5 Years30.0 Years30.5 Years31.0 Years31.5 Years32.0 Years32.5 Years33.0 Years33.5 Years34.0 Years34.5 Years35.0 Years35.5 Years36.0 Years36.5 Years37.0 Years37.5 Years38.0 Years38.5 Years39.0 Years39.5 Years40.0 Years40.5 Years41.0 Years41.5 Years42.0 Years42.5 Years43.0 Years43.5 Years44.0 Years44.5 Years45.0 Years45.5 Years46.0 Years46.5 Years47.0 Years47.5 Years48.0 Years48.5 Years49.0 Years49.5 Years50.0 YearsGross Monthly Salary ($)Previous EmploymentIf less than 2 years at current employment fill out previous employer information.Previous Employer*Type of Business*Position*Address*Length of Employment*Select0 Years0.5 Years1.0 Years1.5 Years2.0 Years2.5 Years3.0 Years3.5 Years4.0 Years4.5 Years5.0 Years5.5 Years6.0 Years6.5 Years7.0 Years7.5 Years8.0 Years8.5 Years9.0 Years9.5 Years10.0 Years10.5 Years11.0 Years11.5 Years12.0 Years12.5 Years13.0 Years13.5 Years14.0 Years14.5 Years15.0 Years15.5 Years16.0 Years16.5 Years17.0 Years17.5 Years18.0 Years18.5 Years19.0 Years19.5 Years20.0 Years20.5 Years21.0 Years21.5 Years22.0 Years22.5 Years23.0 Years23.5 Years24.0 Years24.5 Years25.0 Years25.5 Years26.0 Years26.5 Years27.0 Years27.5 Years28.0 Years28.5 Years29.0 Years29.5 Years30.0 Years30.5 Years31.0 Years31.5 Years32.0 Years32.5 Years33.0 Years33.5 Years34.0 Years34.5 Years35.0 Years35.5 Years36.0 Years36.5 Years37.0 Years37.5 Years38.0 Years38.5 Years39.0 Years39.5 Years40.0 Years40.5 Years41.0 Years41.5 Years42.0 Years42.5 Years43.0 Years43.5 Years44.0 Years44.5 Years45.0 Years45.5 Years46.0 Years46.5 Years47.0 Years47.5 Years48.0 Years48.5 Years49.0 Years49.5 Years50.0 YearsNumber of ApplicantsIs there 1 or 2 applicants?1 applicant2 applicantsCo-ApplicantYou selected 2 applicants. Please fill out co-applicant information.Name* First Middle Last Address* Street Address City*Province*AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal Code*Years at current residence*Select0 Years0.5 Years1.0 Years1.5 Years2.0 Years2.5 Years3.0 Years3.5 Years4.0 Years4.5 Years5.0 Years5.5 Years6.0 Years6.5 Years7.0 Years7.5 Years8.0 Years8.5 Years9.0 Years9.5 Years10.0 Years10.5 Years11.0 Years11.5 Years12.0 Years12.5 Years13.0 Years13.5 Years14.0 Years14.5 Years15.0 Years15.5 Years16.0 Years16.5 Years17.0 Years17.5 Years18.0 Years18.5 Years19.0 Years19.5 Years20.0 Years20.5 Years21.0 Years21.5 Years22.0 Years22.5 Years23.0 Years23.5 Years24.0 Years24.5 Years25.0 Years25.5 Years26.0 Years26.5 Years27.0 Years27.5 Years28.0 Years28.5 Years29.0 Years29.5 Years30.0 Years30.5 Years31.0 Years31.5 Years32.0 Years32.5 Years33.0 Years33.5 Years34.0 Years34.5 Years35.0 Years35.5 Years36.0 Years36.5 Years37.0 Years37.5 Years38.0 Years38.5 Years39.0 Years39.5 Years40.0 Years40.5 Years41.0 Years41.5 Years42.0 Years42.5 Years43.0 Years43.5 Years44.0 Years44.5 Years45.0 Years45.5 Years46.0 Years46.5 Years47.0 Years47.5 Years48.0 Years48.5 Years49.0 Years49.5 Years50.0 YearsPrevious Address Information (Co-Applicant)If less than 2 years at current residence please fill out previous address information. Previous Address*Since*(indicate the year eg) 1983)Telephone*CellularSocial Insurance NumberDate of Birth* MM slash DD slash YYYY Marital Status Single Common Law Married Widowed Divorced Number of DependantsReal Estate* Home Owner Renter Monthly Mortgage/Rent Payment ($)*Value of Real Estate ($)Mortgage Balance ($)Previous Bankruptcy Y/N?NoYesEmployment (co-applicant)Company*Type of Business*Position*Address*City*Province*AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal Code*Length of Employment*Select0 Years0.5 Years1.0 Years1.5 Years2.0 Years2.5 Years3.0 Years3.5 Years4.0 Years4.5 Years5.0 Years5.5 Years6.0 Years6.5 Years7.0 Years7.5 Years8.0 Years8.5 Years9.0 Years9.5 Years10.0 Years10.5 Years11.0 Years11.5 Years12.0 Years12.5 Years13.0 Years13.5 Years14.0 Years14.5 Years15.0 Years15.5 Years16.0 Years16.5 Years17.0 Years17.5 Years18.0 Years18.5 Years19.0 Years19.5 Years20.0 Years20.5 Years21.0 Years21.5 Years22.0 Years22.5 Years23.0 Years23.5 Years24.0 Years24.5 Years25.0 Years25.5 Years26.0 Years26.5 Years27.0 Years27.5 Years28.0 Years28.5 Years29.0 Years29.5 Years30.0 Years30.5 Years31.0 Years31.5 Years32.0 Years32.5 Years33.0 Years33.5 Years34.0 Years34.5 Years35.0 Years35.5 Years36.0 Years36.5 Years37.0 Years37.5 Years38.0 Years38.5 Years39.0 Years39.5 Years40.0 Years40.5 Years41.0 Years41.5 Years42.0 Years42.5 Years43.0 Years43.5 Years44.0 Years44.5 Years45.0 Years45.5 Years46.0 Years46.5 Years47.0 Years47.5 Years48.0 Years48.5 Years49.0 Years49.5 Years50.0 YearsGross Monthly Salary ($)Previous Employment (Co-Applicant)If less than 2 years at current employment fill out previous employer information.Previous Employer*Type of Business*Position*Address*Length of Employment*Select0 Years0.5 Years1.0 Years1.5 Years2.0 Years2.5 Years3.0 Years3.5 Years4.0 Years4.5 Years5.0 Years5.5 Years6.0 Years6.5 Years7.0 Years7.5 Years8.0 Years8.5 Years9.0 Years9.5 Years10.0 Years10.5 Years11.0 Years11.5 Years12.0 Years12.5 Years13.0 Years13.5 Years14.0 Years14.5 Years15.0 Years15.5 Years16.0 Years16.5 Years17.0 Years17.5 Years18.0 Years18.5 Years19.0 Years19.5 Years20.0 Years20.5 Years21.0 Years21.5 Years22.0 Years22.5 Years23.0 Years23.5 Years24.0 Years24.5 Years25.0 Years25.5 Years26.0 Years26.5 Years27.0 Years27.5 Years28.0 Years28.5 Years29.0 Years29.5 Years30.0 Years30.5 Years31.0 Years31.5 Years32.0 Years32.5 Years33.0 Years33.5 Years34.0 Years34.5 Years35.0 Years35.5 Years36.0 Years36.5 Years37.0 Years37.5 Years38.0 Years38.5 Years39.0 Years39.5 Years40.0 Years40.5 Years41.0 Years41.5 Years42.0 Years42.5 Years43.0 Years43.5 Years44.0 Years44.5 Years45.0 Years45.5 Years46.0 Years46.5 Years47.0 Years47.5 Years48.0 Years48.5 Years49.0 Years49.5 Years50.0 YearsDealer Information (Purchasing From)Vendor* Vendor Name Private Sale Still Shopping Name*ContactTelephoneEquipment DescriptionItem #1Quantity*Unit Price*Decription*(year, make, model) Add a second item Item #2QuantityUnit PriceDecription(year, make, model)Payment TermsFinanced Amount ($) - All Financed Amounts Are Based On A 66 Month Term* If there is a comment you would like to leave to accompany your form submission, please click here. CommentsConsent*The undersigned certifies the above information to be true and correct. BY SIGNING BELOW, I/WE CONSENT TO THE OBTAINING FROM ANY CREDIT REPORTING AGENCY OR CREDIT GRANTOR, SUCH INFORMATION AS POLARIS LEASING MAY REQUIRE AT ANY TIME IN CONNECTION WITH THE CREDIT HEREBY APPLIED FOR, and consent to the disclosure at any time of any information concerning the undersigned to any credit reporting agency or to any credit grantor with whom the undersigned has financial relations. I Agree CAPTCHA