Car Loan Application Form
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1
2THE MARITIME FINANCIAL GROUP
Fidelity Finance and Leasing Company Limited
#29 Tenth Avenue, Barataria. Phone # 674-0130 Fax # 675-2830
Email Address
fidelity@maritime.co.tt
CAR LOAN APPLICATION FORM
PERSONAL INFORMATION
Name (1)
Name (2)
(Co-Applicant or Surety)
Relation:
Current Address
Current Address
Number of years at this address
Number of years at this address
Previous address if less than 2 years
Previous address if less than 2 years
Status: Owner occupied Tenanted Other ______________
Status: Owner occupied Tenanted Other
Name of Landlord_______________ Phone #_______________
____________
Name of Landlord_______________ Phone #_______________
Home Phone #________________ Cell # ____________________
Home Phone #________________ Cell # ____________________
Email address _________________________ Fax #___________
Email address _________________________ Fax #___________
Driver’s Permit #_________________ Photocopy Verified
Driver’s Permit #_________________ Photocopy Verified
Date of Birth
Age
Date of Birth
Age
Status Single Married Widowed Divorced
Status Single Married Widowed Divorced
Nationality
Nationality
Dependents (State Number)
Dependents (State Number)
Details
Details
Employment Information
Employment Information
Team Member Agent
Name of Employer
Name of Employer
Address
Address
Department _______________ Manager ____________________
Department_________________ Manager ___________________
Phone #_________________ Ext#________Fax#______________
Phone #_________________Ext #_________ Fax#_____________
Position Held
Position Held
Status Full-Time Temp Probation Contract
Status Full-Time Temp Probation Contract
Details
Details
Number of years in this employment
Number of years in this employment
Previous employer if less than 2 years
Previous employer if less than 2 years
Spouse’s Name
Spouse’s Name
Spouse’s Employment
Spouse’s Employment
Address
Address
Telephone #
Ext. #
Telephone #
Ext. #
Income $
(if applicable)
Income $
(if applicable)
Please give us the name of a close friend-address other than own
Please give us the name of a close friend-address other than own
Name
Relation
Name
Relation
Address
Address
Phone no.
Phone no.
Employed at
Employed at
Work phone contact
Ext. #
Work phone contact
Ext. #
Existing TMFG client
How Long
Yes
No
FFLC
MLCL
MARGEN
DOLLAR VALUES ONLY
FINANCIAL INFORMATION
Savings/Chequing/Fixed Deposits / Accounts at Banks/Financial Institutions/Credit Union/Other
Bank/Fin. Inst.
Branch/Contact
Type of Deposit
Account No.
A/C Opened
Balance
1.
$
2.
Short Term Credit Facilities Bank/Financial Institution/Credit Union/Other
Lender
Branch/
Orig. Amt/
Balance
Mthly
Arrears/
Security
Contact
O/Draft Lt.
Inst.
Date Paid To
1.
2.
Long Term Credit Facilities (Real Estate)
Location
Market Value
Mortgagee/
Mortgage O/S
Repymt
Arrears/
Insurance
(Indicate if Land only)
Contact
Date Paid To
1.
2.
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Parent category: Business